1 Running head: PROFESSIONAL DEVELOPMENT PLAN

Professional Development Plan Michelle M. Johnston Ferris State University

2 PROFESSIONAL DEVELOPMENT PLAN Abstract This paper is one that is analytical and informative of this writers practice and long-term goals for her future in nursing. This paper will guide its reader through the ten standards of professional nursing performance as it relates to this writer. Each of the ten standards of professional performance will be described and this writer will analyze her practice, finding both strengths and weaknesses as it relates to each standard. The strengths and weaknesses will be identified providing examples. Both five and ten year goals of this writer will then be revealed. The goals in professional practice will be given with a timeline and plan for obtainment. The evaluation plan of those goals will then be revealed. This paper should provide its reader with an overall understanding of this writers current practice and future goals.

3 PROFESSIONAL DEVELOPMENT PLAN Professional Development Plan The professional field of nursing practice is regulated and expected to meet certain standards. The American Nurses Association (ANA) has set standards of performance for practicing professional nurses. The purpose of this paper is to lead the reader through the analysis of the standards of professional nursing practice as it relates to my profession. I will analyze my strengths and weaknesses as they relate to each standard of performance providing examples throughout the paper, and I will provide information regarding my long-term goals. My five and ten year goals will be identified with a plan to achieve and evaluate those goals throughout my professional practice. Standards of Professional Nursing Performance Standard #7: Ethics There is a standard of ethics in professional nursing that the ANA expects nurses to uphold. The ANA (2010) states that the registered nurse: delivers care in a manner that preserves and protects healthcare consumer autonomy, dignity, rights, values, and beliefs (p. 47). This standard is in place to protect patients/resident/clients from unethical care. In my professional nursing practice I practice ethically and hold myself to the high standard of ethics that the ANA has identified. I include my patients in planning of care and I am sure to keep them and their families informed of their status and options for treatment (2010, p. 47). I have much strength in following the standard of ethics identified by the ANA. I am sure to follow this standard daily in my practice, for example, a patients family member came in to visit on a day when the patient was out to the hospital. I could not tell the family member where the patient was because she was not the Durable Power of Attorney (DPOA), but I did tell her that she could call the DPOA herself and ask questions regarding the patients status.

4 PROFESSIONAL DEVELOPMENT PLAN Withholding personal protected information about that patient is an example of how I was following the ethics standard and keeping the patients healthcare information confidential within legal and regulatory parameters (2010, p. 47). My weaknesses regarding the standard of ethics would be that I am not always trying to resolve ethical issues in my practice if they are not directly affecting me. The ANA (2010) states the registered nurse: contributes to resolving ethical issues involving healthcare consumers, colleagues, community groups, systems, and other stakeholders (p. 47). I feel that I could do more about this, but as of now, I am only working two days a week. In my future, I plan to work on meeting this standard to the fullest. Standard #8: Education Education as a standard for professional nursing performance is identified by the ANA to set a standard for nurses to keep current in their practice, and continue their education. As stated by the ANA (2010), the registered nurse attains knowledge and competence that reflects current nursing practice (p. 49). This standard is one that impacts my practice greatly. I need to keep current on medications and new products that are being used to care for the elderly or those in rehab. The education standard affects my practice. I am meeting the standard of education and I believe I have many strengths in meeting this standard. I am currently pursuing my Bachelors of Science in Nursing (BSN) and I plan to continue my education to obtain a masters degree. I keep current on changes in my profession by attending classes that provide knowledge and learning credits offered by my employer. I am always trying to find ways to incorporate what I am learning in my BSN studies to my practice. An example of my incorporating things that I have learned into my practice is me talking with my Director of Nursing (DON) about the

5 PROFESSIONAL DEVELOPMENT PLAN evidence found to support individualized toileting schedules over the two hour toileting schedule. I am also trying to inform my coworkers of the things that I am learning in school or from doing my own research. The ANA (2010) states that the registered nurse: contributes to a work environment conducive to the education healthcare professionals (p. 49). I feel that I am contributing in a way that is meeting the standard. The only weakness that I feel I have with the standard of education is that I am currently not keeping a record of my learning projects that would provide evidence of competence and lifelong learning. I have made a portfolio before, though I have not continued to add projects to that portfolio. I do plan to start keeping a record of my learning projects as I have recently made a new online professional portfolio. Standard #9: Evidence Based Practice and Research There is a standard of evidence based practice and research in nursing. The nursing profession is one that is based upon evidence. As a nurse I do not do what I believe is the right thing to do without any evidence that what I am doing is going to work. Each nursing action that I can take has some evidence attached to it. Nursing practice is changing with research and evidence all the time. It is important for nurses to keep current on the evidence and research as well as to do their own research and provide their own evidence for why they do what they do. As stated by the ANA (2010), the registered nurse integrates evidence and research findings into practice (p. 51). My strength in meeting the practice standard is that I use current evidence-based nursing knowledge and research to guide my practice (ANA, 2010, p. 51). Currently I am implementing the use of incentive spirometry into my practice to prevent pulmonary complications in my patients. I am quick to tell my coworkers about new research that I have found as well, and

6 PROFESSIONAL DEVELOPMENT PLAN when a change in my practice has been made, I question it to be sure that there is supporting evidence of why we are doing what it is we are doing (2010, p. 51). I could not find any exact weakness with this practice standard as of now, but I am sure that I could do more of my own research outside of my practice. Standard #10: Quality of Practice The standard of quality of practice in the nursing profession is all encompassing of every other standard. Quality of practice means that the nurse is doing all in his/her power to be sure to deliver quality care and improve his/her practice. The standard can be met by the nurse meeting all other standards. This standard is something that can be measured by the nurse or others in the healthcare team. In my practice, I am contributing to quality. I am looking for creative ways to enhance the care I give (ANA, 2010, p. 52). For example: one of my patients was having frequent episodes of emesis after meals. I paid close attention to these occurrences for a few days and was able to correlate it with drinking the cranberry juice we serve at my facility. I then implemented giving this patient other options besides cranberry and found that she was no longer having emesis. I care planned that the patient was not to have cranberry juice and she has not had emesis after meals since. Other strengths in meeting this standard are that I am sure to pay close attention to cost savings (2010, p. 52). I have brought cost savings by keeping toiletry items with patients as they move room to room rather than throwing them away to the attention of my DON as well as my staff coordinator who is now involving the intervention in training new employees. My weakness in meeting this standard is that I often am not a part of making decisions based on quality. Most of the larger decisions are made by upper management in meetings that I

7 PROFESSIONAL DEVELOPMENT PLAN am not invited to attend. If I notice issues I do bring them to the attention of the quality nurse, though I do not often find any issues.Standard #11: Communication Communication is a very important standard identified by the ANA. According to the ANA (2010), the registered nurse communicates effectively in a variety of formats in all areas of practice (p. 54). Communicating effectively is a large part of caring for others as a professional nurse. If a nurse cannot communicate, then the job cannot be done. In my practice I display the competency of conveying information to my patients, families, and other members of the healthcare team in ways that are accurate and are sure to provide quality (ANA, 2010, p. 54). I normally will speak to the physicians by telephone using the SBAR tool to help me convey appropriate and necessary information. I am sure to read back all orders to the physician to be sure that I have written the orders correctly and to prevent error. When I speak with families and patients I try to speak and hold my body language in a way that is non-threatening and sensitive to the patients situation. I am always sure to find ways to improve my communication with my patients and their families and to find ways to improve communication with my coworkers (2010, p. 54). My shortcomings in meeting the standard of communication are that I am not always sure who to bring my concerns to while I am at work. I often bring issues to my DON, but there are times when I feel that I am bothering her. I am trying to improve upon this and learn from past experiences, though I believe I have some ways to go. Standard #12: Leadership The registered nurse demonstrates leadership in the professional practice setting and the profession as stated by the ANA (2010) (p. 55). Leadership is important in nursing. The

8 PROFESSIONAL DEVELOPMENT PLAN registered nurse is expected to guide his/her coworkers and set the direction of care of patients. Good leadership skills are essential in registered nursing practice. As a leader, I am able to hold myself accountable for the actions of others that I lead (ANA, 2010, p. 55). I am able to use my communication skills to delegate care and resolve conflicts within my practice (2010, p. 55). In recent times I have had to resolve conflict on my unit between two Certified Nursing Assistants CNAs. The conflict was resolved by pulling the two CNAs aside and leading a conversation about the issue and thoughts about how we can resolve the issues. Since the time of conflict resolution, the two CNAs have worked well together and there have not been any issues regarding the conflict. The leadership skills that I have and the competencies I meet for this standard are close to completely meeting the standard; however, I do have a weakness in the area of leadership. My weakness is that I do not belong to any professional organization. The lack of belonging to a professional organization can limit my leadership skills. In the future, I plan to become a member of a professional organization such as the ANA. Standard #13: Collaboration Collaboration is the partnering of the nurse with others to provide quality care. The standard of collaboration is met daily in my practice and shown by my working with other members of the healthcare team to care for my patients. According to the ANA (2010), the registered nurse: communicates with the healthcare consumer, the family, and healthcare providers regarding healthcare consumer care and the nurses role in the provision of that care (p. 57). I am sure to involve the patient, their family, the physician, and at times therapies in producing the care plan. In my practice, I am unable to carry out orders unless they are approved by a physician. Daily, there are issues that come about in which I need to call the physician to

9 PROFESSIONAL DEVELOPMENT PLAN ask for orders and during these times it is expected that I communicate and work with the physician effectively and accurately to provide quality care for my patients. My weaknesses in collaboration are that I could do more to find ways to improve the quality of care of many patients by collaborating with other members of the healthcare team. I am a resource nurse, therefore I only work when there are open shifts and I frequently change units which can make it difficult to follow up with a patient to be sure that issues are being resolved. Standard #14: Professional Practice Evaluation In order for a nurse to grow professionally, he/she has to evaluate their practice and get a baseline for where they are in growth. It would be difficult to say that I am a good nurse if I have never heard anyone tell me that I am a good nurse or if I have never asked for feedback from superiors or coworkers. The ANA (2010) states that the registered nurse: engages in selfevaluation of practice on a regular basis, identifying areas of strength as well as areas in which professional growth would be beneficial (p. 59). This paper is an example of an evaluation of practice. In my earlier practice as a nurse, I was always asking for feedback from other nurses. I wanted to know if I was indeed doing things correctly and with accuracy. In my current practice, I am evaluating my communication and my care delivery skills each day I work. I am looking for feedback from my peers and my patients as well as from patient families. This standard of professional performance evaluation is one that is not without difficulty in achieving. I feel that I have many weaknesses in this area as I have not met many of the competencies. I often do not participate in peer review nor do I provide much feedback to my peers about their own professional practice (ANA, 2010, p. 59). As a new nurse, I do not feel

10 PROFESSIONAL DEVELOPMENT PLAN that it is appropriate for me to provide any criticism, either good or bad, to others because I am not sure if I am doing everything correctly myself. Standard #15: Resource Utilization There are plenty of resources offered to provide nurses with the correct information that they will need to be successful in their practice. A nurse needs to be knowledgeable about his/her practice and anything surrounding it. The competency that I believe I best meet is that I assess the needs of my patients and find the appropriate resources to help achieve the goals and outcomes that are set in place for them (ANA, 2010, p.60). I am aware of my resources and I often will seek them if there is a task that is too difficult or if I need help. I am able to delegate care appropriately and consult the correct professionals when issues arise and their consultation is necessary (2010, p. 60). My weaknesses in meeting the standard of resource utilization is that there are times when I am not sure of who to look to for help and there are also times when the person I normally count on is not available. I am learning quickly who to go to in these situations, but I believe there is much room for improvement. Standard #16: Environmental Health The environment in which a nurse works is to be healthy and inviting for those who need care. It is important that the nurse practice in an environmentally safe and healthy manner (ANA, 2010, p. 61). I am sure to practice in a way that is environmentally safe for my patients. There are times when the hallways are too noisy or there are rooms that are not clean. In situations when the environment is not conducive to healing, I take it upon myself as the registered nurse to bring things to order. When equipment is not working properly or there is a

11 PROFESSIONAL DEVELOPMENT PLAN threat to safety in the environment, I am sure to contact our maintenance and get the problems resolved right away. Safety is always my number one priority in my practice. My weakness in this area would be that there are times when I do not have time to do rounds to be sure and assess that the environment is safe for my patients. In the future, I will be doing my best to focus more on meeting this standard. Long-term Goals Five Year Goals I have identified four goals that I would like to have completed by or within the next five years. My first goal is to join a professional organization. I believe that joining a professional organization would help to keep me current with new research and evidence based practices as well as promotes my leadership skills. My second goal is to complete my BSN, which will make me more appealing to other healthcare organizations in my practice. The third goal that I have is to obtain a job in a more acute setting. I would like to gain more experience in an acute setting rather than the sub-acute that I am working in now. My fourth and final five year goal is to enter and begin a masters program for my Masters of Science in Nursing (MSN) degree. Ten Year Goals My ten year goals are not as solid as my five year goals. I have identified two goals which I would like to have met by or within ten years. My first goal is to complete my MSN degree. I have always wanted to become a nurse educator, though I will need much experience before beginning this. The second ten year goal that I have is to find a field in nursing that I really enjoy working in and have a job in it. I love nursing, but I have only ever worked in subacute rehab or long-term care, so I am not sure what I will end up enjoying the most.

12 PROFESSIONAL DEVELOPMENT PLAN Evaluation My five year goals all seem manageable and realistic. I plan to join a professional organization this upcoming year 2013 and I plan on joining the ANA because they are a broadpurpose professional association (Chitty & Black, 2011, p. 363). After this semester, I will have fifteen credits completed towards my BSN degree which required me to take thirty seven credits with Ferris State University (FSU). I am enrolled in nine credits for next semester and I plan to have my entire BSN degree completed by December of 2013. My evaluation of that goal will happen once December of 2013 gets here. I still have to do a little more research into the accelerated RN to MSN program because I may be interested in doing that through FSU. To meet my third goal, I will wait until I am nearly finished with my BSN degree to apply to any hospitals in my area. I have a few different hospitals to choose from, which are: Spectrum Butterworth/Blodgett, Metro Health, and Saint Marys. I have not yet decided which hospital to work for, but I plan to start seeking a position on a medical surgical unit so I can gain more basic nursing knowledge and skill before moving to a more specialized unit. My third goal should be obtained by January of 2014. My fourth goal of being accepted and beginning by MSN degree in education will come after I have had a solid two years of full time employment as a registered nurse, which is the requirement (Ferris State University, n.d). This goal should be obtained by August of 2016. My ten year goals are not quite as solid as my five year goals, but I do have a timeline for them to be obtained. My plan to obtain my first goal of obtaining my MSN degree should be completed by the end of ten years 2022. I would like to complete this degree quickly, though I am not set in my plan because I would like to gain some experience as a floor nurse working in an area of nursing that I believe I would enjoy teaching first. I would need to complete a total of

13 PROFESSIONAL DEVELOPMENT PLAN thirty six credits to complete my MSN degree in education (Ferris State University, n.d.). My goal will be to try and take two classes per semester, but I will not rush myself through the program. According to the American Association of Colleges of Nursing (2012), the shortage of faculty is contributing to the current nursing shortage by limiting the number of students admitted to nursing programs(para. 4). The need for nursing educators will only increase with time and I would love to fill a position as an educator in my future. To meet my second goal of finding a job in an area of nursing that I love, I plan to first become employed in an acute setting and possibly change areas within the next ten years to find what area I prefer. The area of nursing that I prefer to work in will also be the area of nursing that I would prefer to teach. Conclusion In writing this paper, I have been able to thoroughly analyze my practice as it relates to the standards of professional nursing practice identified by the ANA. I have been able to step away from what I do day to day to look at my practice as a professional nurse and make myself aware of areas that I need to improve. I found that there are many areas which could use improvement in my practice and will make me a better nurse. By presenting my five and ten year goals, I can see areas where I may need to do some improvement there as well. I can see that I need more information regarding my MSN and that I need to make improvements as soon as possible. I am now able to look at my practice and see what I have achieved and what I need to work on in order to be the best possible professional nurse that I can be.

14 PROFESSIONAL DEVELOPMENT PLAN References American Association of Colleges of Nursing [AACN]. (2012). Faculty shortages in baccalaureate and graduate nursing programs: Scope of the problem and strategies for expanding the supply (para. 4). Retrieved from https://fsulearn.ferris.edu/webapps/portal/frameset.jsp?tab_group=courses&url=%2Fweb apps%2Fblackboard%2Fexecute%2Fcontent%2Ffile%3Fcmd%3Dview%26content_id% 3D_51505_1%26course_id%3D_2055_1%26framesetWrapped%3Dtrue American Nurses Association [ANA] (2010). Nursing: Scope and standards of practice (2nd ed.). Silver Spring, MD: Author. Chitty, K. K., & Black, B. P. (2011). Professional nursing: Concepts and challenges (6th ed.). Maryland Heights, MO: Saunders. Ferris State University. (n.d). Programs and degrees: Nursing MSN. Retrieved from http://www.ferris.edu/HTMLS/statewide/programs/masters/msn.htm. Retrieved on December 6, 2012.

15 PROFESSIONAL DEVELOPMENT PLAN Appendix A CHECKLIST FOR SUBMITTING PAPERS CHECK DATE, TIME, & INITIAL yes yes

PROOFREAD FOR: APA ISSUES

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1. Page Numbers: Did you number your pages using the automatic functions of your Word program? [p. 230 and example on p. 40)] 2. Running head: Does the Running head: have a small h? Is it on every page? Is it less than 50 spaces total? Is the title of the Running head in all caps? Is it 1/2 from the top of your title page? (Should be a few words from the title of your paper). [p. 229 and example on p. 40] 3. Abstract: Make sure your abstract begins on a new page. Is there a label of Abstract and it is centered at the top of the page? Is it a single paragraph? Is the paragraph flush with the margin without an indentation? Is your abstract a summary of your entire paper? Remember it is not an introduction to your paper. Someone should be able to read the abstract and know what to find in your paper. [p. 25 and example on p. 41] 4. Introduction: Did you repeat the title of your paper on your first page of content? Do not use Introduction as a heading following the title. The first paragraph clearly implies the introduction and no heading is needed. [p. 27 and example on p. 42] 5. Margins: Did you leave 1 on all sides? [p. 229] 6. Double-spacing: Did you double-space throughout? No triple or extra spaces between sections or paragraphs except in special circumstances. This includes the reference page. [p. 229 and example on p. 40-59] 7. Line Length and Alignment: Did you use the flush-left style, and leave the right margin uneven, or ragged? [p. 229] 8. Paragraphs and Indentation: Did you indent the first line of every paragraph? See P. 229 for exceptions. 9. Spacing After Punctuation Marks: Did you space once at the end of separate parts of a reference and initials in a persons name? Do not space after periods in abbreviations. Space twice after punctuation marks at the end of a sentence. [p. 8788] 10. Typeface: Did you use Times Roman 12-point font? [p. 228] 11. Abbreviation: Did you explain each abbreviation the first time you used it? [p. 106-111] 12. Plagiarism: Cite all sources! If you say something that is not your original idea, it must be cited. You may be citing many timesthis is what you are supposed to be doing! [p. 170] 13. Direct Quote: A direct quote is exact words taken from another. An example with citation would look like this: The variables that impact the etiology and the human response to various disease states will be explored (Bell-Scriber, 2007, p. 1). Please note where the quotation marks are placed, where the final period is placed,

16 PROFESSIONAL DEVELOPMENT PLAN no first name of author, and inclusion of page number, etc. Do all direct quotes look like this? [p. 170-172] 14. Quotes Over 40 Words: Did you make block quotes out of any direct quotes that are 40 words or longer? [p. 170-172] 15. Paraphrase: A paraphrase citation would look like this: Patients respond to illnesses in various ways depending on a number of factors that will be explored (Bell-Scriber, 2007). It may also look like this: Bell-Scriber (2007) found that [p. 171 and multiple examples in text on p. 40-59] For multiple references within the same paragraph see page 174. 16. Headings: Did you check your headings for proper levels? [p. 62-63]. 17. General Guidelines for References: A. Did you start the References on a new page? [p. 37] B. Did you cut and paste references on your reference page? If so, check to make sure they are in correct APA format. Often they are not and must be adapted. Make sure all fonts are the same. C. Is your reference list double spaced with hanging indents? [p. 37] PROOFREAD FOR GRAMMAR, SPELLING, PUNCTUATION, & STRUCTURE 18. Did you follow the assignment rubric? Did you make headings that address each major section? (Required to point out where you addressed each section.) 19. Watch for run-on or long, cumbersome sentences. Read it out loud without pausing unless punctuation is present. If you become breathless or it doesnt make sense, you need to rephrase or break the sentence into 2 or more smaller sentences. Did you do this? 20. Wordiness: check for the words that, and the. If not necessary, did you omit? 21. Conversational tone: Dont write as if you are talking to someone in a casual way. For example, Well so I couldnt believe nurses did such things! or I was in total shock over that. Did you stay in a formal/professional tone? 22. Avoid contractions. i.e. dont, cant, wont, etc. Did you spell these out? 23. Did you check to make sure there are no hyphens and broken words in the right margin? 24. Do not use etc. or "i.e." in formal writing unless in parenthesis. Did you check for improper use of etc. & i.e.? 25. Stay in subject agreement. When referring to 1 nurse, dont refer to the nurse as they or them. Also, in referring to a human, dont refer to the person as that, but rather who. For example: The nurse that gave the injection. Should be The nurse who gave the injection Did you check for subject agreement? 26. Dont refer to us, we, our, within the paperthis is not about you and me. Be clear in identifying. For example dont say Our profession uses empirical data to support . . Instead say The nursing profession uses empirical data.. 27. Did you check your sentences to make sure you did not end them with a preposition? For example, I witnessed activities that I was not happy with. Instead, I witnessed activities with which I was not happy.

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17 PROFESSIONAL DEVELOPMENT PLAN yes 28. Did you run a Spellcheck? Did you proofread in addition to running the Spellcheck? yes 29. Did you have other people read your paper? Did they find any areas confusing? yes 30. Did you include a summary or conclusion heading and section to wrap up your paper? No 31. Does your paper have sentence fragments? Do you have complete sentences? yes 32. Did you check apostrophes for correct possessive use. Dont use apostrophes unless it is showing possession and then be sure it is in the correct location. The exception is with the word it. Its = it is. Its is possessive. Signing below indicates you have proofread your paper for the errors in the checklist: ________________________________________________________DATE:________12/6/12__ ______