Professional Nursing E-portfolio

Introductory Page

Name: Autumn Joyce

Title: Staff Nurse and Student

Personal Statement

A philosophy is the study of the fundamental nature of knowledge, realities and existence especially when considered as an academic discipline. A set of views and theories of a particular philosopher concerning such study or an aspect of it. The ethical values I hold are respect, autonomy, beneficence, non-malficence, justice, veracity and fidelity. Others around me find that I treat my patients with the up most respect at all times. When I have patients that tell me not to change, I feel proud that I became a nurse so that I can help others. I give my patients freedom of choice and I try my best to prevent harm. The theories that I consider using in my practice is the Watson’s Philosophy of Nursing and Caring.

Current Resume

Autumn Joyce, R.N.

103-06 217th Street

Queens Village, NY 11429

T 917-855-1566

autumn.joyce@aol.com

JOB TARGET

Obtain a long term position with a medical facility that will benefit from my academic preparation, nursing experience and a driving work ethic.

Skills

  • 4 years of experience in Medical-Surgical Nursing.
  • Energetic and hardworking with the ability to adapt to the environment very easily
  • Exceptionally good communication and demonstration skills
  • Great ability to deal with the problems and queries of patient and their families.
  • Provided the competent and dignified patient care.
  • ANA, NSO and NYSNA member.

Education & certifications

New York City College of Technology, Brooklyn, NY

Bachelors of Science Degree, Nursing, Expected graduation 05/2013

Associates in Applied Science Degree,  2005-2009

Basic Life Support Certified & Advanced Cardiac Life Support Certified

Experience

Staff Nurse/Charge Nurse, Kings County Hospital; Brooklyn, NY- 2009-Present

Medical-Surgical Nursing

Admit and discharge patients. Assigned duties to nursing personnel and supervise nursing staff. Communicated patient’s needs, deliver direct patient care, assess patient’s physical, psychosocial and emotional needs. Provided patient and family teaching, inform physician of patient’s status. Administer medications as ordered, served as a resource person for knowledge of medication’s use, side effects and dosage, checked for proper medication orders, document medications, obtain required consent forms and perform other duties as required.

Nurse Intern, Kings County Hospital; Brooklyn, NY- 2008-2009

Shadow and assisted the nurse with patient care, medication administration and nurse’s notes. Assist the patient with task they can not provide for themselves such as eating, taking a bath, getting out of bed, brushing teeth and hair. Take vital signs and report abnormal levels to nurse. Perform other duties as required.

Reference

Furnished upon request

 

Cover Letter to Graduate School Coordinator

Dear Graduate Coordinator,

I am very interested in pursing a masters degree at the SUNY Downstate in nurse practitioner. From my review of graduate programs and discussion with other professionals it is very evident that SUNY Downstate’s program has an excellent Nurse Practitioner Program.

I am completing a very comprehensive Undergraduate Program in Bachelors of Science at New York City College of Technology. As you can see by my resume, this program has prepared me well for the graduate education challenges I now wish to pursue. I hope that the skills and knowledge I obtain from this graduate degree will give me the opportunity to seek a challenging opportunity within a dynamic setting.

I have enclosed all materials required for acceptance into the masters program. Thank you very much for your consideration of my application.

Very truly yours,

Autumn Joyce, RN

Thank You Note

ATTN: Graduate Coordinator

SUNY Downstate

470 Clarkson Avenue Brooklyn, New York

718-270-1000

December 4th, 2012

Subject: Thank You

The purpose of this letter is to convey appreciation and gratitude for aiding my academic endeavors. Thank you for taking the time to interview me regarding my application to the Graduate Program. I know I would be an asset to the SUNY Downstate.

I am very interested in continuing my studies at SUNY Downstate and look forward to hearing from you soon.

Sincerely,

Autumn Joyce, RN

Individual Strength

I consider myself to be a creative person. I love to think about new ways to do things and have came up with many solutions to complex problems. Open- mindedness is one of my strengths. When faced with a problem, I find that I think it through and examine them from all sides. I am a cultural competent person because I try to learn about other’s cultures in order to provide better care of the patients. I am a leader in that I encourage others to get things done and able to supervise others without an issue. I build close relationships with others and enjoy doing favors and good deeds for others. I am very fair in the things I do and sometimes try to find humor in certain situations.

Learning Self-Analysis for the Nursing Program

I started my education at New York City College of Technology in 2005. I have a lot of family members that are nurses so it was natural for me to choose nursing as my path. i was lucky to achieve the grades to be accepted into the Associates Program at NYCCT. I have to say that the first semester was a little challenging for me. This was a new world with a very different language. I was successful in completing the Associates Program with blood, sweat and most times tears. I was very lucky that i did not have to repeat any courses. The Bachelors Program gave me insight on a new way to look at nursing. With more leadership, management, research and community oriented skills, i was able to blossom as a more effective leader in school and at work. At times there were challenges but nothing that could not be handled. Overall, I am very happy I chose the Nursing Program at NYCCT because i have grown tremendously, meet great friends and faculty members and I will be walking away with a vast amount of knowledge.

 

One Sample of a Written Assignment

Important Issues in the Nursing Profession

Autumn Joyce

Professor Dato

Professional Nursing

Due: November 28, 2012

In the nursing profession, there are many critical issues that are challenging amongst us today. Three of these issues are safe staffing, preventing medications errors and higher level of education and training through an improved education system that promotes seamless academic progression. These issues can cause deadly consequences to patients and staff members. Changes in legislation needs to be made in order for us to move on and be a safer nation.

Safe staffing is the appropriate levels of nurses and ancillary personnel needed to always meet the needs of the patient. Many facilities are neglecting safe staffing to save money. When there is safe staffing, their is reduced hospital-acquired infections, length of stay, nurse turnover and hospital cost. Safe staffing also improves patient satisfaction, nurse retention and productivity. Safe staffing can be achieved by staffing plans that account for the individual needs of each patient care unit.

According to Safe Staffing: the Registered Nurse Safe Staffing Act, the American Nurses Association, supports the Registered Nurse Safe Staffing Act which would require Medicare participating hospitals through a committee compromised of at least 55% direct care nurses or their representatives, establish and publicly report unity-by-unit staffing plans.  This act would establish a minimum number of registered nurses, be based upon patient numbers and the variable intensity of care needed, ensure that RNs are not forced to work in units where they are not trained or experienced among many other entities. Unsafe staffing ratios forces nurses to use shortcuts which can jeopardize safe patient care. Nurses are being burnt out and want to spend less times in direct patient care because of a rough work environment where they are constantly stressed out. Therefore this is a significant problem in the nursing community. According to Huston, “numerous studies in the last decade have examined the link between staffing mix and patient outcomes. Much, but not all, of the research has suggested a link between the increased representation of the RNs in the staffing mix and improved patient outcomes.”

My experience with inadequate staffing issues is vast. I work for a city hospital in Brooklyn where the patients are very ill with numerous health conditions. Can you imagine two registered nurses working on a unit with 21 patients, which includes two ventilator patients, admissions and transfers, blood transfusions, pain management among many other aspects of care that has to be provided. On my unit, that is a regular occasion. One nurse has 11 patients and the other nurse who is also in charge of the unit has 10 patients. How can scenarios like this ever be considered safe? When staffing is like this on the unit, patient care most times are not being completed, you are not able to turn immobile patients every two hours to prevent skin breakdowns, hourly rounds can not be made, it is basically impossible to function like this. There is lack of support from administrators because when you voice your concerns, who are be shunned upon as if you are saying something wrong, when you are only trying to advocate for better staffing ratios and safe patient outcomes.

Medical errors are defined as incorrect actions or plans that may or may not cause harm to patient. According to Huston, “ the Joint Commission reported that errors associated with medications are believed to be the most common type of medical error and are a significant cause of preventable adverse events. Medication errors occur because of poor communication between health care providers, poor communication between providers and their patients, sound alike medication names and medical abbreviations, illegible prescriptions or confusing directions, poor teaching among many other reasons. This is a significant problem in nursing because medication errors can cause serious harm to patients. A 2006 follow-up on the IOM study found that medication errors are one of the most common mistakes made and accounts for at least 1.5 million people being harmed every year. According to a 2002 Agency for Healthcare Research and Quality report, about 7,000 people were estimated to die each year from medication errors. According to Nurse Staffing is an important strategy to prevent medication errors by Frith, Anderson, Tseng and Fong, “ the study adds to the body of evidence that patient care is most safely delivered when there are enough RN care hours and when LPN hours are reduced or eliminated. The cost associated with RN hours must be balanced against the cost of an error”.

In my personal experience, their are always instances where the staff members have to be in-services because of medication errors. For instance, a nurse gives the patient insulin for a blood glucose of 185 mg/dl. She called the doctor and told the doctor the repeat blood glucose which was 100 mg/dl. The doctor orders 10  units of Aspart insulin stat and the patient winded up coding on the unit. This was a medication error on  both the nurse and doctor’s part. If adequate communication was conducted then this incident would be avoided.

Patient’s themselves also commit medication error. When a patient does not have enough money to buy their medication sometimes they take half their dose of medication or skip doses.  Many clients admit to skipping medications because their blood pressures were normal when in fact they need to take it to maintain their blood pressure in a normal range. These are all examples of medication errors. The impact of this is that lives are being affected because of this. Adverse reaction can cause readmission to the hospital.

The third important issue in the nursing profession is the issue that nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progress. According to the IOM report, major changes in the U.S. health care system and practice environment will require equally profound changes in the education of nurses both before and after they receive their license. In order to deliver safe, quality, patient-centered care across all settings, especially in areas such as primary care, community and public health, current and future generations need improved education systems. For many years now, its been greatly debated over the qualifications and level of education required for entry into the nursing profession. According to the IOM report, “competencies needed to practice have expanded, especially in the domains of community and public health, geriatrics, leadership, health policy, system improvement and change, research and evidence-based practice, and teamwork and collaboration”.

Why do we need nurses to be more competent in terms of advanced education? We are living in a country where care for the patient’s are becoming more complex. Nurses have to make more critical decisions because patients are becoming more sick. The need for nurses to fill primary roles and to help patients manage chronic illnesses thereby preventing acute care episodes and disease progression have increased. Nursing shortages in certain positions continue to have a strong impact in the advancing of the profession and improving the delivery of care to patients.

How do we solve the issue? According to the IOM report one step is to realize that more nurses need to enter the workforce with a baccalaureate degree or progress to this earlier in their career.  Nursing education should also have seamless transition from LPN to RN, BSN and MSN. Emphasis needs to be placed  on cultural competency and the increasing diversity that we face today in the workforce. We work with many different cultures especially in urban areas. Adequate education needs to be provided so we are not bias against the cultures of others.

In my estimation, education is very important for any nurse. In nursing things change on a continuous basis. We always have to keep abreast on new things so we can provided adequate care for our patient. My experience with education and my job is that the facility wants you to get the higher degree but do not want to accommodate the time needed for school. When someone has to work the night shift and then leave school and sleep in their vehicle so they do not miss work, you can tell how hard it is for that person because your job does not want to give you the day off. That is my experience currently.  My thought process is that I need to finish school so I can advance in my career. At certain facilities, it is so hard to move away from bedside nursing and advance in nursing even though you have the educational skills. Strategies can be scaled up and refined to effect the needed transformation of nursing education.

In conclusion, many issues affect nurses and patient safety. The three issues that were discussed were safe staffing, medication errors and improvements in nursing education. These issues are important because they impact the safety of patients every day. Medication errors, safe staffing and improvements in nursing education can have deadly consequences to the patients. These issues need to be addressed in order to improve patient care. All in all, changes need to be made in the nursing profession.

Reference

Huston, C.J. (2010). Professional Issues in Nursing: Challenges and Opportunities. Philadelphia. PA: Lippincott Williams & Wilkins.

Safe Staffing Saves Lives.org (2012)

Retrieved from http://www.safestaffingsaveslives.org/WhatisSafeStaffing.aspx Accessed on November 19,2012

Safe Staffing: The Registered Nurse Safe Staffing Act (2012)

Retrieved from http://www.nursingworld.org/SafeStaffingFactsheet.aspx Accessed on November 19,2012

Frith, K.H., Anderson, E., Fan, T., & Fong, E.A. (2012). Nurse Staffing Is an Important Strategy to Prevent Medication Errors in Community Hospitals. Nursing Economics, 30(5), 288-294.

Institute of Medicine. (2010). The Future of Nursing: Leading Change, Advancing health.

Retrieved from http://www.nap.edu/catalog.php?record_id=12956 on November 19,2012

Sample Blogs

Blog #4, Shore Hill Housing 9000 Shore Rd, Brooklyn, NY 11209, November 7th, 2012

Today we meet with the Professor in morning conference to discuss the plan for the day, Hurricane Sandy and the issues we faced during the storm. Everyone was okay but some had some damages to their properties including myself. We were able to see a senior resident today who was bed bound. We were greeted by her home attendant. She asked us if we were from a agency because her agency told her not to let anyone in because they might try to steal her job. We assured her that we were students from CityTech. She agreed to let us in. The apartment was well kept and clean. The senior client was lying in her bed and was watching television. We got a chance to interview the client and ask her what medications he was on. She was unable to tell us what medications she was on therefore the home attendant provided us with a list from her doctor of all the medications she was on. The client has dementia. She was able to recall who the president of the United States was because President Obama had won the re-election last night. She was able to recall what day it was but unable to tell her own age. She stated, “I am old.” The home attendant complained of the lack of pay and the other issues she was having with the job. She was getting paid for 12 hours although she works 24 hours a day, 4 days a week. This was a meaningful experience for me because it showed me that we have to appreciate what we have now because their will be a point in life where some of us can’t do for ourselves anymore and we have to rely on others to take care of us. This experience makes me want to be closer to family members and friends, more close than I am now. Sometimes we work in addition to going to school and taking care of family that we don’t have time for our loved ones but we need to make time and enjoy these moments.