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Patients with cardiac problems can be treated either with a help of drug therapy, regular outpatient consultations, day-care, hospital admissions, pacemaker insertions, or, in extreme cases, both minor and major surgeries are used (Bethann, 2008). In my experience during practicum in the cardiac field, I realized that such kind of problems imposed burdens to the family and society of the affected patients. The costs of managing and treating such diseases as well as the inability of such people to do all activities by themselves contribute to big sacrifices from the families of those affected (Bethann, 2008).
In my practicum I was able to have clinical experiences in leadership and collaboration. I also was able to develop consultation skills, comprehend ethical conduct, and other professional peculiarities. Leadership was demonstrated through initiation of consultation during which I was able to gain and use consultation skills. I was able to collaborate with fellow staff during my practicum especially when we were sharing information. The main benefit I got during the practicum was the ability to explore core competencies of CNS, the overview of which I will provide further in this paper.
One of the CNS competencies developed during my practicum was direct care competency where I interacted directly with patients suffering from cardiac problems and their families. In those situations I used various methods of developing the competency. First, I used advanced skills to communicate with the patient. These are skills within therapeutic relationships. Since my patients had multiple needs, the application of advanced nursing therapies and schemes was performed. Using the signs and symptoms evident in every cardiac problem, I was able to alienate different diagnostic procedures for each condition. All these were based on direct clinical practice and professional ethical decisions.
Before diagnosing patients, I studied information about the disease and factors related to the disease. In this way I was able to come up with plans of appropriate care that should be given to such patients (Bennet, et. al 2009). Assessments were conducted using techniques that had previously been tested and have evidence of success. These practices not only helped me develop competency, but also allowed me to fulfill my goal of developing proper management strategies for cardiac patients.
Evaluation of the effectiveness of addressing the above competency is done in three ways. First, clinical assessment is done by evaluating patient’s health condition. I would say I succeeded in this case because most of my patients’ wellbeing improved. Secondly, I evaluated myself functionally. I could see that some of the patients I dealt with were able to resume their roles in society and most of the time they showed signs of good health.
The second CNS competency that I addressed is consultation competency. Here, I was expected to use interaction between patients and nurse staff in order to help my patient overcome his or her problem. While dealing with this issue, I initiated consultations. I ensured that all consultation information was passed to the necessary personnel. I also used records of previous and current consultations for the purpose of developing knowledge and making improvements.
The next competency that was achieved to some extent is the collaboration competency (Thompson & Cathy, 2011). I should say that some of the achievements were made with the help of others: the patient, family, community and staff. In as much as I was interested in cardiac disorders, I collaborated with staff in other departments e.g. staff at the surgical department. With a help of such collaborations I was also able to form a team the main aim of which was to improve the efficiency of the whole system.
As stated above, this competency was developed using help of others mainly because in some cases assembling all the teams at the same time was almost impossible. The time I spent doing my practicum was not enough for the full development of the competency. One of the factors affecting accuracy of information is the number of people who helped further develop my ability to facilitate communication among different departments.
Systems leadership competency was also addressed since I was able to use the knowledge I gained to empower others. This competency was not fully developed. However, I was able to perform assessments of the environment surroundings the patient, population age, the quality of health care delivery system and different practices used by the staff. I was also able to evaluate how these practices affect patients. Research and analysis of available data enabled me to determine the methods that had positive effects to the family and the patient. With the help of other staff members and available community I was able to evaluate the impact of cardiovascular nursing system on both the patient and nurse. Being a nurse, I was able to use the knowledge I had gained to specify outcomes that could be expected.
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The challenging part of addressing this competency was when I was required to implement a system that would have a positive effect on patients and their families. During my practicum my proposal for using an interdisciplinary approach to achieve better results had to be reviewed by several people for approval. It was also difficult for me to come up with age- specific procedures for diagnosing patients with cardiac disorders. I was unable to obtain information about budgets and thus I had difficulties in making suggestions for system changes. To some extent, this competency was poorly accomplished due to inability to access information relating to budget.
Coaching competency was part of the CNS competencies I was expected to show. To address this competency, I used my knowledge as a CNS nurse in advising families about the care of patients with cardiac problems. I was also in a position to use the knowledge I had gained to modify treatment strategies for patients with cardiac problems. After the realization that most of my patients and families were not well informed about their condition, I developed an educational program for the relevant people with cardiac disorders. In order to facilitate learning I also developed a program for students interested in cardiac nursing. In the future, I have plans of becoming a mentor for those interested in my field in order to fully accomplish this competency.
As mentioned above, one of the clinical experiences was in ethical decision-making. This is a competency whereby I was expected to take action on ethical issues affecting the patient, system, family, health care provider, community, and family. This competency was accomplished by explaining to the patient and family members about their condition, how it can be managed, and the effects of each management system. Through collaboration with various councilors I was able to create a climate that allowed the provision of ethical care. I asked my peers and staff for evaluation by encouraging them to provide me with information on how I could improve myself. I can say that this competency was achieved due to what I was able to do during my practicum.
The other competency is research competency where I was expected to do systematic inquiry and use evidence-based methods and strategies in my everyday work. The first step to develop this competency was to apply the practices and products that are evidenced to have positive effects on the patient. I was also able to come up with a program that could improve the system. Finally, I did some reading and any new information that I obtained was critically evaluated. The last thing I accomplished in this competency was the identification of a problematic area in which I plan to carry out further research. There is still a lot of work to be done in accomplishing this competency. I spent few weeks doing my practicum and some of the CNS competencies were not developed. Inefficient amount of time also made it difficult to achieve some of my goals. However, having enough time during my continued practicum, I intend to fulfill all my goals and develop all the competencies fully.
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My plan involves consulting advanced nurses about the practice. This will help me to better understand what is required of me in that field. With the information and experience I have gained from my practicum so far I will approach my patients more confidently. This will enable me to communicate more effectively with them. I realized that I was not able to do an extensive research during my practicum so this will also be a part of the future extended practicum. The research will be based on analysis of available data, use of evidence, analysis of the system and health personnel. I will identify an area of inquiry, use relevant tools to collect data while considering ethical principles in the process. Not only will this enable me to develop all CNS competencies, but will also help to achieve the goal of devising appropriate management strategies. One of my goals is to gain exhaustive knowledge on Acute Coronary Syndrome and this can only be accomplished through research. At this point, I would like to point out that my main plan is to accomplish my professional goals.