3 1 Reflection Paper Michael Hayes Texas Tech University Health Sciences Center

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Reflection Paper

Michael Hayes

Texas Tech University Health Sciences Center School of Nursing

NURS-4234: Integrating BSN Concepts

Professor Heather K. Morris,

April 7, 2024

Reflection Paper

In this paper, I explore my transformative journey from an associate degree-prepared Registered Nurse (RN) to a bachelor’s-prepared RN, highlighting the profound improvements in my clinical practice, leadership, decision-making, and overall philosophy towards nursing. Through my experience in a Bachelor of Science in Nursing (BSN) program, I have gained expanded competencies that have specifically advanced operations within a catheterization laboratory (Cath Lab) setting. This paper discusses how the integration of patient-centered care, bolstered by evidence-based practice, has developed in my nursing practice. It also examines the evolution of my leadership capabilities, which are crucial for coordinating a multidisciplinary team. Participating in this program has honed my critical thinking abilities, which are crucial for navigating intricate clinical environments. Furthermore, I have developed a fresh perspective on the nursing profession, recognizing it not as a collection of separate tasks but as a collaborative effort to achieve top-quality patient care through systemic excellence and teamwork. I have also realized that nurses play a critical role in assessing research for clinical decision-making, highlighting the importance of nursing leadership in care delivery. Lastly, I have explored how the program has enabled me to identify my leadership style and its potential to facilitate my professional and personal growth.

Practice Changes

As I transitioned from an associate degree-prepared RN to a bachelor’s-prepared RN, the Differentiated Essential Competencies (DECs) outlined by the Texas Board of Nursing have been instrumental in defining and enhancing my practice, particularly in my role within the Cath Lab. These competencies have deepened my understanding of patient-centered care, emphasizing the integration of evidence-based practice and research into clinical decisions. This framework is crucial for addressing our patients’ complex and unpredictable needs, enabling me to develop more effective care plans and interventions. Furthermore, the DECs have fostered the growth of my leadership and management skills, which are essential for coordinating our multidisciplinary Cath Lab team and ensuring efficient operations. They also broadened my perspective on healthcare by incorporating community and public health, thus enriching my approach to providing holistic care in a high-stakes environment. Enhanced critical thinking skills, nurtured through rigorous liberal arts and advanced nursing education, allow for nuanced clinical judgments essential for the dynamic Cath Lab setting. The emphasis on lifelong learning and professional development within the DECs framework ensures that I stay current with advances in cardiovascular technology and treatments, empowering me to lead, innovate, and continually improve our practices (Texas Board of Nursing, 2021). I am better positioned to enhance patient care and team performance through these comprehensive competencies.

Thinking Change

My perspective on nursing has evolved significantly since advancing my education from an RN to a BSN. I now view nursing as an individual effort and a collective endeavor, where high-quality patient care results from high-quality team members working within a high-quality system. This shift in thinking aligns with the differentiated essential competencies highlighted by the Texas Board of Nursing, which stresses the importance of collaboration and leadership among nurses at the baccalaureate level (Texas Board of Nursing, 2021). My BSN education has emphasized the critical role of systemic thinking in preventing adverse outcomes and improving patient care. For instance, in considering adverse drug events, it is evident that errors often stem not from individual negligence but from systemic failures. This reinforces my belief that enhancing systemic protocols and fostering a culture of teamwork and mutual accountability is pivotal to elevating patient care standards (Harkness & Pullen, 2019). This means advocating for robust checks and balances in medication administration, promoting interprofessional communication, and leading efforts to cultivate a healthcare environment where collective responsibility for patient safety is a shared priority.

Feelings Change

The BSN program has profoundly transformed my feelings about nursing, reinforcing the evolving educational paradigms and the profession’s expectations highlighted in recent literature. The “Future of Nursing 2020–2030” report, as Bodine (2023) discussed, underscores a crucial shift toward health equity and the expansive role nurses must play in achieving this goal. This report has reshaped my perspective, emphasizing the importance of being well-versed in managing social determinants of health and advocating for systemic changes to support health equity. The call for promoting nurses’ health and well-being in the report resonates deeply with me, illuminating the reciprocal relationship where the well-being of nurses is as pivotal as the health of their patients. It has inspired me to view nursing not just as patient care but as a broader social initiative that requires collective efforts to reform practices and educational structures to address healthcare disparities better. This holistic view perfectly aligns with the BSN program’s aim to prepare nurses as caregivers and critical actors in the public health ecosystem, capable of leading change and promoting a healthier, more equitable society.

Surprising Revelations

One of the most surprising things I have learned in my nursing practice is nurses’ critical role in evaluating research to guide clinical decisions. Initially, I believed that such responsibilities lay primarily with physicians. Still, I have come to understand that nurses, too, must engage deeply with research to ensure that our practices are evidence-based. The tool designed by Melnyk (2016) has been invaluable in providing a structured approach to assess the quality and applicability of research findings effectively. This tool empowers me to focus my limited time and energy on interventions supported by robust evidence, thereby enhancing patient care outcomes. Using the PICOT framework to formulate specific clinical questions and then applying the levels of the evidence pyramid, I can critically appraise the available research and determine the best practice changes. This systematic approach has transformed how I perceive my role in healthcare, shifting from passive practice application to active, informed decision-making.

Self-Awareness

One of the most significant revelations about myself during the completion of this program has been recognizing my own leadership style and communication preferences. Through the introspective analysis facilitated by leadership theories such as Path-Goal, Leader-Member Exchange, and Transformational Leadership, I have identified a supportive style that aligns with my core values of empathy and care, which are crucial for nursing. This self-assessment has illuminated my strengths and areas for improvement, particularly highlighting my need for greater adaptability and proactive communication within my team dynamics. Understanding these aspects has profoundly motivated me to refine my approach and evolve continuously as a nursing leader, aiming to effectively navigate the complex, changing scenarios that characterize healthcare settings. This journey of self-discovery, as detailed in the Leadership Self-Assessment document, has enriched my professional growth and set a clear path for my future endeavors in leadership roles​ (Dare and Saleem, 2022).

Conclusion

In conclusion, this paper has explored my transformative journey through the BSN program, answering critical questions about my professional evolution. First, my practice has diversified significantly, enhancing my capabilities in patient-centered care and evidence-based practice within the cath lab setting. Second, my thinking has shifted from individualistic to systemic, recognizing nursing as a collective endeavor essential for high-quality care. Third, I feel a renewed passion for nursing, driven by understanding its broader social impacts and the need for health equity. Fourth, the most surprising revelation has been the critical role of nurses in research and evidence-based clinical decision-making, a responsibility I previously thought was reserved for physicians. Lastly, the biggest thing I have learned about myself is my inherent leadership style—supportive and empathetic—bolstering my ability to lead effectively in complex healthcare environments. These insights underscores profound personal and professional growth, setting a firm foundation for my future nursing and healthcare leadership contributions.

References

Bodine, J. (2023). The Future of Nursing 2020–2030. Journal for Nurses in Professional Development, 39 (2), 115–116. doi: 10.1097/NND.0000000000000975.

Dare, P. S., & Saleem, A. (2022). Toward Success While Tackling the Change in A Pandemic Age: Path-Goal Theory Leadership as a Win-Win Gadget. Frontiers in Psychology, 13. https://doi.org/10.3389/fpsyg.2022.944145

Harkness, T. L., & Pullen, R. L. (2019). Quality improvement tools for nursing practice. Nursing Made Incredibly Easy, 17(3), 47–51. https://doi.org/10.1097/01.nme.0000554602.68360.ed

Melnyk, B. M. (2016). Level of evidence plus critical appraisal of its quality yields confidence to implement Evidence-Based practice changes. Worldviews on Evidence-based Nursing, 13(5), 337–339. https://doi.org/10.1111/wvn.12181

Texas Board of Nursing. (2021, January 21). Differentiated Essential Competencies of Graduates of Texas Nursing Programs. Retrieved April 6, 2024, from https://www.bon.texas.gov/pdfs/publication_pdfs/DifferentiatedEssentialCompetencies2021.pdf