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Posts by jenannebeard
Joined: Dec 1, 2011
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jenannebeard   
Dec 1, 2011
Writing Feedback / 'to change my current job status' (Career Plan) [NEW]

Never been a good writer. I'm very anxious when it comes to writing any paper. Please help me out if you care to do so ;) Much appreciated!!!!

RN - BSN Bridge Course: Career Plan
N300W: RN - BSN Bridge Course
Jennifer A. Beard
California State University, Chico

If you were to ask me three years ago when I graduated with an associate's degree in nursing if I wanted to return back to school to get my bachelor's degree, my answer would have been no. I was 26 years old at that time and haven't had a break from school for longer than a month since my college years begun. I was emotionally, physically, and psychologically drained from school. The thought of no longer staying up till the early morning studying made me ecstatic. I could finally just work which entailed doing something I loved, and get paid for it. Unfortunately, things didn't go accordingly as I had planned for myself. The economy took a fall at the time I finished my associate's degree and it affected my chances in getting a job as a nurse at the current hospital I was working at. The new grad program for nurses was eliminated and no nurses without prior acute care experience would get hired. I used to blame the situation around my uncannily bad luck. I would painfully remind myself every day if I had graduated one semester earlier I wouldn't be in this predicament. But since then I've learned to let go and face the obstacles I've been dealt with. I decided to take an on-call job as a nurse at a long-term/rehabilitation nursing home. It was then when I realized I needed to go back to school. My 10-year plan for my nursing career is to obtain my Bachelor's of Science in Nursing, continue to work in a capacity that will increase my skill-set as a RN, become a Registered Nurse for a large hospital, and go into a specialized field where I can focus my nursing skills to a specific area of expertise.

I was desperate to do anything in my power to change my current job status. I can't even count how many times I cried after a shift or wanted to quit on the spot. The only thing that prevented me from doing so was the thought that I may not be given another chance. Thankfully, I work at a different long-term/rehabilitation nursing home now that I enjoy better. The amount of support I receive from my co-workers at my current job makes a world of difference. But I still yearn to be a nurse at a hospital and attaining my bachelor's degree in nursing just might be the ticket to get there. The job market is very competitive right now and to attract attention I'm trying to make myself more marketable. I've noticed a high trend amongst employers' in their preference for registered nurses with a bachelors degree and I only expect this to become a norm in the future. According to one survey I found consisting of a chair nursing officers in 2010, 71% identified differences in levels of practice and skill between associate and baccalaureate degree nurses, and noted that their preference for hiring would be baccalaureate-prepared nurses (Lane et al., 2010). They also noted that baccalaureate nurses had better critical thinking skills, more professional behaviors, leadership skills, and holistic approaches (Lane et al., 2010). I am very pleased to know this might increase my chances in getting a hospital job. In addition, attaining a bachelor's degree in nursing will also create more job opportunities for me in my future. Bedside nursing is hard physical work, and I don't see myself doing it forever, especially with old age.

Staying on the path I am on now I will graduate next summer with a bachelor's degree in nursing. It's been a very challenging road working two jobs and trying to maintain a social life at the same time, but with my hard work and perseverance I'm confident I will make this happen. I decided to fore go with my decision to go back to school now because the timing was right. I don't have children yet and my husband and I are in a good financial state to do so. Everything seemed to line up in order for me to pursue my dreams.

A second goal I'd like to attain is gain more confidence in my current job role. I've been in my current job role as a charge nurse at a long-term/rehabilitation home for three months. Since I first got hired I can tell my confidence level has raised some, but I still am very apprehensive the days I go to work. In order to gain more confidence as a nurse, I need to identify what actions I should take to make my transition to practice a learning experience. As a rather new nurse still, my skills and experience lack. I feel improving my skills and gaining more experience is the answer to increasing my confidence level.

During my mission in finding what strategies I should employ at work to enhance my learning, I came across the National Council of State Boards of Nursing (NCSBN) website. Over the years, NCSBN and boards of nursing have looked at the issue of training and retention of young nurses. They've found that the inability of new nurses to properly transition into new practice can have grave consequences. With increasingly sicker patients these days, more than 40% of new nurses report they've made a medication error. Increased stress levels experienced by new nurses also is an additional risk factor associated with patient safety and practice errors. And approximately 25% of new nurses leave a position within their first year of practice which in turn negatively influences patient safety and health care outcomes (National Council of State Boards Nursing, 2011, Transition to Practice section, para. 5). NCSBN has addressed there is a need for a consistent training regimen for new nurses that should be replicated across the country to ensure consistent quality of care and drop the alarming turnover rates of new nurses.

After a review of the evidence and input from the state boards of nursing (BONs) and the nursing community, an evidence-based transition model was developed. The Transition-to-Practice regulatory model was designed; it includes all health-care settings that hire newly licensed nurses and all educational levels of nurses. The five transition modules for this model is supported by evidence and based on the Institute of Medicine (IOM) competencies and the Quality and Safety for Nursing Education initiative. They include patient centered care, communication and teamwork, evidence-based practice, quality improvement, and informatics (Spector & Li, 2011, pp 20-21). Feedback and reflection are important factors in this model. Bjřrk and Kirkevold's (1999) longitudinal study also showed the importance of feedback and reflection. Their study illustrated that if new nurses do not receive feedback on their practice, along with an opportunity to reflect, their practice will not improve. Without those opportunities for feedback and reflection, new graduates are at risk for making the same mistakes repeatedly.

In attempt to raise my confidence level further, I will take these modules from The Transition-to-Practice regulatory model into account. I will continue to collaborate with my co-workers and stress my concern with them about my level of practice. I will encourage them to give me any constructive feedback they may have to offer. I will reflect back on what I could have done differently in certain situations so I can learn for the future. Luckily for myself, I work with a great team of nurses. Many of them make themselves available and approachable. I feel I am able to ask questions without being ridiculed and they are more than willing to back me up when I'm having a problem. A great support system I feel will encourage, and strengthen me as a nurse, thereby giving me the courage and confidence I need as a new nurse to practice competently, safely, and effectively. I plan to obtain a higher sense of confidence in one year implementing these strategies. And I have the utmost confidence I will.

As I continue working as a charge nurse at a long-term/rehabilitation nursing home throughout my Bachelor's degree program, I will have gained over two years professional experience. This experience will aid in my next goal of becoming an emergency room nurse at a hospital by the end of 2013. To become an ER nurse, additional certifications are required. I already have my ACLS certification and my basic heart monitoring certification. However, to specialize in emergency room care, I will need to pass the Certified Emergency Nurse exam, which will need to be done through the Emergency Nurses Association. This course will optimize my chances for success after I'm in an emergency nursing position by fine-tuning my skills (Emergency Nurses Association, 2011, Why Emergency Nursing? section, para 7). I will pass this exam as well as sharpen my skills in assessment, ABG and EKG interpretation, and IV access. In addition, I would like to become a Certified Pediatric Emergency Nurse as this is usually desired by hospitals as well. Once I become an ER nurse, I would like to learn and develop my skills further for the next 1 to 2 years in a full-time position. Once I feel confident in my abilities, I would like to switch to part-time and meet my goals of becoming a mother in 2015. Working part-time for the next 5 to 7 years will allow me to watch my children grow; I don't want to miss out on all their milestones. Also, working part-time will still provide me with the experience needed to transition to my end goal of becoming an operating room nurse.

Becoming a scrub nurse in the operating room by 2021 is my lifetime goal. By this time, my children will be in school so transitioning back to a full-time nurse to take in all there is to learn in this field would be great timing. A scrub nurse works directly with surgeons within a sterile field, passing instruments, sponges, and other items needed during the procedure (Association of Operating Room Nurses, 2011, Roles of the Perioperative Nurse section, para. 2). As stated on the Association of Operating Room Nurses website, most medical facilities do have programs that will help you attain the necessary experience. But two areas that can give you some applicable experience are critical care and emergency room care. Therefore, I am hoping becoming an ER nurse will increase my chances in attaining a perioperative nurse position. In addition I would like to become CNOR (Certified Nurse Operating Room) certified. Voluntarily getting CNOR certified displays personal and professional commitment to patient care. It increases the patient's confidence in the care they receive, enhances your professional credibility, and is highly valued by other nurses and members of the healthcare team (Association of Operating Room Nurses, 2011, CNOR Certification section, para. 3). Lastly I will become a member of the Association of Operating Room Nurses. The benefits to becoming a member include access to valuable education resources, becoming an advocate for your profession, and support from the perioperative community to further personal and professional development. (Association of Operating Room Nurses, 2011, Experience the Benefits of Membership section, para. 1). To achieve my 10-year plan for my nursing career it will take determination, continuous learning, and concentration, but I am up for the challenge.

References

Association of Operating Room Nurses. (2011). Consider a career in the OR as a perioperative nurse.

Bjork, I., & Kirkevold, M. (1999). Issues in nurses' practical skill development in the clinical setting. Journal of Nursing Care Quality, 14(1), 72-84.

Emergency Nurses Association. (2011). Why Emergency Nursing?

Lane, S. H., & Kohlenberg, E. (2010). The Future of Baccalaureate Degrees for Nurses Susan H. Lane, and Eileen Kohlenberg The Future of Baccalaureate Degrees for Nurses. Nursing Forum, 45(4), 218-227.

Spector, N., & Li, S. (2007). A regulatory model on transitioning nurses from education to practice. JONA's Health-care Law, Ethics and Regulation, 9(1), 19-22.
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