Danneil Clarke's ePortfolio

My name is Danneil Clarke,RN. I’m 24 years old, from Jamaica West Indies. From a young age I knew that I wanted to be in a profession that was caring and able to help people, as I got older I looked into nursing and knew that’s where I should be. I’m currently a nurse case manager and enjoy what I do. I also have experience working with patients on ventilators and geriatric patients. I am an extremely organized, calm, and patient professional with excellent healthcare skills. I have a passion for providing quality care to patients and making them feel their best. I desire to be a trauma nurse one day. Welcome to my e-portfolio.

Looking back, I was a timid student who thought I could go through the nursing program with no problem, but I got a reality check very quickly. I was going to go through many trials and tribulations, many defeats but also success.

As I grow I realize that I have built up my patience greatly, not everything goes how you want it to immediately, you have to be patient and resilient. I’ve also learned how to work along side other people, I’ve always been a loner and try to get things done on my own. But working as a nurse I’ve realize everything is a team effort and you wont be able to survive on your own. My observational skills have also increased immensely, I’ve always been observant but now I’m able to pick up on very little details. I am so proud of myself and where I came from and I can’t wait to continue to build and be the best I can be.

Danneil Clarke,RN

(917)770-6125                                                                                              clarke.danneil@gmail.com

Professional Summary

Compassionate Registered Nurse with excellent communication skills and dedicated work ethics, great team player, seeking position in a facility that manages both common and complex medical conditions in patients of all ages.

Education

New York City College of Technology

• Associate in Science in Nursing                                                December 2015
• Bachelors in Science in Nursing January 2016- Present

Skills

• Excellent observational and communicational skills
• Great understanding of basic Computer skills/programs
• Great comprehension and retention
• Great assessment skills

Licenses

• Registered Nurse in the State of New York                  License # 714850      April 2016- Present
• Pharmacy Technician                                     January 2015-Present
• CPR/AED                                                                                          June 2016-Present
• Certified Nursing Assistant                                                 June 2010-Present
• CPI Nonviolent Crisis Intervention Certificate      September 2014- Present

Professional Experience

Cerebral Palsy Associates of New York

Nurse Case Manager                                                                                     April 2017-Present

• Coordinate all aspects of the care of individual patients. Ensure proper utilization of services and resources as well. Provide assistance within, between, and outside of facilities. Work along side patients, families and other professionals.

HASC- Remsen School

Staff nurse                                                                                            September 2016- Present

• Obtain and maintain medical records for both staff and students. Tend to children that have special needs (from autism to adhd) with medical conditions such as asthma, diabetes, trach and minor medical issues. Administer medications as needed.

New York Film Academy

Staff Nurse-(summer program)

• Obtain medical history and tend to children and staff on minor injuries.     June 2016 – August 2016

Promenade Rehabilitation and Long term Care Center

Staff and Charge Nurse                                                                                      April 2016 – August 2016

• Recognize emergency situations and act effectively according to protocols; assume personal responsibility for safe work habits and patient safety, Utilized/enforced universal precautions, provided direct care to patients in the following age group: Geriatrics, middle and young adult. Tend to ventilated patients with medication administration and respiratory difficulties. Supervise other faculty.

Rite Aid Pharmacy

Pharmacist Technician                                                                                      October 2013- Present

• Under supervision of a pharmacist type prescription, count and dispense medications, answering questions related to medication within my scope of practice.

Professional Organizations

• Nutrix                           January 2012- May 2013

References– Available upon request.

Growth is something I strive for whether it’s with my family, friendships or career. As a new nurse I was scared of not being able to grasp new concepts but with time and patience, I was able to gain so much knowledge. My journey through the baccalaureate program has not been an easy one. Managing work life, social and school has been a great task. Through out the different classes I was able to build on my time management, better assessments, and managing different cases. This has brought me great insight and has built on my knowledge from the associates program. It has made me feel confident in being able to attend graduate school and further my education.

In nursing I feel we play a vital role in patient care. We are the caregivers and advocators, we see patients through their darkest hours sometimes. Other disciplinary may come and go but we should maintain a listening ear. We should also be observant, just because a patient may be nonverbal they might give cues and insight to how they are feeling and by taking the time out to observe we gain information on how to make their lives better. As a nurse you utilize all you have to allow this person to live an optimal lifestyle, you listen, advocate and even give a gentle smile to make their day. I believe that we can bring the sunshine to the cloudiest of days and that’s our duty as nurses. Well that’s the reason I became a nurse.

Nursing Staffing and Quality of Care

An outcome of quality patient care and decrease in mortality rate is one of the reasons I decided to join the health field and become the best nurse I could possibly be. Surveys have shown that the main reasons why people join the health field is to be able to take care of people and for financial reasons. You want to take care of as many people as possible and give each patient one hundred percent of your best efforts and time, but what if, your staffing ratio to patients doesn’t allow that? This has been a topic of discussion for years and even when they “fix” the problem, there will be someone that thinks the ratio is unsatisfactory.

Lets start with a nurse’s job description. A nurse has to play many roles while in the healthcare setting. A nurse has direct other healthcare personnel, record information pertaining to the patients and the staff, make care plans along with other disciplinary, monitor patients symptoms and changes, administer medications, answer any questions related to nursing, order and interpret labs, act in the cases of emergency and be the patients advocate. These few descriptions don’t begin to show all that a nurse does but they play many roles and have to do this with several patients at a time.

I believe that nursing to patient ratios should be based on the units that the nurse is working in. Some units require the nurse to spend more time with the patients as well as the stability of the patients can also vary from stable to critical. Even though it is known that a patient’s status can change at any given moment, within the unit the chances decrease of any changes. “Consistent evidence from observational studies suggest that an increase in registered nurse to patient ratios was associated with reduction in hospital related mortality, failure to rescue and other nurse sensitive outcomes” (Keck,R.2010).

The department of professional employees conducted a study that compared California to New Jersey and Pennsylvania because California has a minimum nursing requirement law which is based on the units a Registered Nurse is within, for intensive Care its 1:2, Operating room 1:1,Post anesthesia care unit 1:2, Labor and delivery 1:2,Emergency room 1:4,Trauma patients within the emergency room 1:1, Telemetry 1:4,Psychiatric 1:6,Medical Surgical 1:5 and other specialties 1:4. These were just a few of the main units within a hospital.

Based on the study it showed a significant difference, New Jersey and Pennsylvania doesn’t have minimum or maximum requirement for nurses to patient ratio so the management is able to regulate it to their own needs and not think about the patients or the nurses that may be mentally or physically drained. The study showed “that seventy-three percent of the nurses in California found their workload to be manageable compared to the sixty-one percent in Pennsylvania and the fifty-nine percent in New Jersey” (Frederick,R.,Tullen,J.T 2011)”. The study also showed results of the burnout rates of the nurses being significantly less than those in California, which can automatically lead to the assumption of more malpractice and injuries occurring.

Another study done by the AHRQ- Agency for Healthcare Research and Quality, which is a government agency, ran by the department of health showed significant results within five different studies. In hospitals with higher registered nursing staffs the patients had a lower rate of unfavorable outcomes, “such as longer hospital stay, pneumonia, urinary tract infection’s and gastrointestinal bleeding, than those with lower staffing. Also patients with major surgeries had lower adverse outcomes  such as urinary tract infections and failure to survive. The other study found that each additional surgical patient per nurse was associated with a seven percent higher likelihood of dying within thirty days of admission and a seven percent higher likelihood of failure to rescue. Another study resulted in a thirty day mortality rates among AIDS patients being lower where there was both a higher nurse-patient ratio and an AIDS specialty physician service. (Albertin, K.Cen, L.Till,P. 2014)”

Within all the healthcare providers wanting to have a mandated nurse to patient ratio there is an opposition, in that some healthcare workers don’t want that bill passed. They believe that its not a one size fits all scenario. They feel as though every hospital and healthcare setting is dynamic and all have different needs. To have a mandated bill pass, “people may lose their jobs in order for them to fit the standards of the law, also units may have to be shut down if they are unable to meet those specifics (Keck,R. 2010)” which would cause a lot of re-routing and turning down certain patients.

Mandating to some healthcare personnel seems inefficient because “every patients needs are individually different and must be evaluated to see what their needs are” (Keck,R.2010), staffing amongst hospitals are different in terms of the level of skills and the actual individuals. So mandating a ratio makes it unreasonably difficult and unfair to certain hospitals. Not all nursing staff will be equivalent in terms of education, skills, background and how long they have been a nurse. There are too many variations to have a one-size fit all law for healthcare.

Since California’s mandated ratio law they have had positive outcomes but also a lot of set backs, they have experienced downsizing due to the fact that they were now “over staffed” in some settings by the new law. Also transfers are more difficult now because every facility has to make sure they are within the law before accepting anyone new, Emergency room bypass was another thing that was greatly impacted because of the law some emergency rooms that are fully capable have to turn people down in order to stay within the proper parameters. One of the greatest impacts that the state had to endure when the mandated law was passed was that twelve hospitals had to go into closure. Showing that the nursing staff cannot be broken down numerically but needs another strategy in making the ratio ideal for nurses as well as patients.

Some hospitals have been doing a quarterly report on the nursing staff to each unit and also factor in the patient outcomes. This has shown to be a good process and keeps the statistic within the hospital up to par. With this strategy it’s keened to the individual hospital and the units within it, making the outcomes favorable. It provides a comprehensible picture of what the ratio is like in the hospital and gives that information to the public allowing them to know the status of their hospital.

Amongst all the studies of having a mandated ratio the results always yielded a positive outcome for patients. From the small study groups to a bigger group it showed significance in the results of how the patient was affected. Many states have been trying to have a bill pass to improve the chances of improving quality of care but many also oppose it. This isn’t going to be something that can be solved overnight but something that needs continuous research. I believe their should be a mandated ratio within each setting because it decreases the chances of nurses being overworked and patients not receiving the quality of care that they need. But I also believe its not a one size fit all scenario. This needs adequate research and a lot of test and trials will have to be done for them to have optimal results.

Citations

– Keck,R. (2010) What’s in the Proposed Law?Nursingworld.org. N.p.,

-Nurse–Patient Staffing Ratios : AJN The American Journal of Nursing. (2008). http://journals.lww.com/ajnonline/Abstract/2013/08000/Nurse_Patient_Staffing_Ratios.17.aspx

-Frederick,R.,Tullen,J.T(2011)”Safe-Staffing Ratios: Benefiting Nurses And Patients” Journal of Nursing Scholarship, . N.p.

-Albertin, K.Cen, L.Till,P. (2014) Hospital Nurse Staffing and Quality of Care | AHRQArchive,https://archive.ahrq.gov/research/findings/factsheets/services/nursestaffing/nursestaff.html