Nursing Role & Scope – Week 4 – Competencies for Professional Nursing Practice

Please answer the questions below:

1.  You are assigned to care for Ms. C., an 81-year-old patient who was admitted today with symptoms of increasing shortness of breath over the last week. She is currently receiving oxygen through a nasal cannula at 3 L/min. You go into the room to assess her. You find that she is sitting up in bed at a 60-degree angle. She is restless and her respirations appear labored and rapid. Her skin is pale with circumoral cyanosis. You ask if she feels more short of breath. Because she is unable to catch her breath enough to speak, she nods her head yes. Which action should you take first? Why?

•      Listen to her breath sounds.

•      Ask when the shortness of breath started.

•      Increase her oxygen flow rate to 6 L/min.

•      Raise the head of the bed from 75 to 85 degrees

     Follow the discussion questions participation and submission guidelines.

·      Follow the 3 x 3 rule: minimum three paragraphs per DQ, with a minimum of three sentences each paragraph.

·      All answers or discussions comments submitted must be in APA format according to Publication Manual American Psychological Association (APA) (6th ed.) 2009 ISBN: 978-1-4338-0561-5

·      Minimum of two references, not older than 2015.

Please provide plagiarism report.

Competencies for Professional Nursing Practice

Chapter 4

Overview Competencies
American Association of Colleges of Nursing (AACN) Essentials
Quality and Safety Education for Nurses (QSEN)
Technology Informatics Guiding Education Reform (TIGER) Initiative
Nurse of the Future (NOF): Nursing Core Competencies

Figure 4-1 The Nurse of the Future: Nursing Core Competencies graphic.
Reproduced from Massachusetts Department of Higher Education. (2016). Nurse of the future: Nursing core competencies:
Registered nurse. Retrieved from http://www.mass.edu/nahi/documents/NOFRNCompetencies_updated_March2016

Nurse of the Future:
Nursing Core Competency Graphic
Illustrates, through use of broken lines, the reciprocal and continuous relationship between each competency and nursing knowledge, that the competencies may overlap and are not mutually exclusive, and that all competencies are of equal importance.
Nursing knowledge is placed as the core in the graphic to illustrate that nursing knowledge reflects the overarching art and science of professional nursing practice.

NOF Core Competency Model
(1 of 3)
Essential knowledge, attitudes, and skills (KAS), reflecting cognitive, affective, and psychomotor learning domains, are specified for each competency.
The KAS identified in the model reflect the expectations for initial nursing practice following the completion of a prelicensure professional nursing education program.

NOF Core Competency Model
(2 of 3)
Human beings/patients: Recipients of nursing care or services; may be individuals, families, groups, communities, or populations
Environment: The atmosphere, milieu, or conditions in which one lives, works, or plays
Health: Experience, often expressed in terms of wellness and illness, that may occur in the presence or absence of disease or injury

NOF Core Competency Model
(3 of 3)
Nursing: The protection, promotion, and optimization of health and abilities; prevention of illness and injury; alleviation of suffering through the diagnosis and treatment of human response; and advocacy in the care of individuals, families, groups, communities, and populations

The NOF Core Competencies
Patient-centered care
Professionalism
Leadership
Systems-based practice
Informatics and technology
Communication
Teamwork and collaboration
Safety
Quality improvement
Evidence-based practice

Why Is Critical Thinking Important in Nursing Practice?
Essential to providing safe, competent, and skillful nursing care.
The inability of a nurse to set priorities and work safely, effectively, and efficiently may delay patient treatment in a critical situation and result in serious life-threatening consequences.

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Thinking Like a Nurse
Clinical judgment
Clinical reasoning
Mindfulness

Clinical Judgment
(1 of 2)
Clinical judgments are more influenced by what nurses bring to the situation than the objective data about the situation at hand.
Sound clinical judgment rests to some degree on knowing the patient and his or her typical pattern of responses, as well as engagement with the patient and his or her concerns.

Clinical Judgment
(2 of 2)
Clinical judgments are influenced by the context in which the situation occurs and the culture of the nursing unit.
Nurses use a variety of reasoning patterns alone or in combination.
Reflection on practice is often triggered by a breakdown in clinical judgment and is critical for the development of clinical knowledge and improvement in clinical reasoning.

Critical Thinking and Clinical Judgment in Nursing
Purposeful, informed, outcome-focused thinking
Carefully identifies key problems, issues, and risks
Based on principles of the nursing process, problem solving, and the scientific method
Applies logic, intuition, and creativity
Driven by patient, family, and community needs
Calls for strategies that make the most of human potential
Requires constant reevaluating

Characteristics of Critical Thinking
Rational and reasonable
Involves conceptualization
Requires reflection
Includes cognitive skills and attitudes
Involves creative thinking
Requires knowledge

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Characteristics of a Critical Thinker
(1 of 2)
Flexible
Bases judgments on facts and reasoning
Doesn’t oversimplify
Examines available evidence before drawing conclusions
Thinks for themselves
Remains open to the need for adjustment and adaptation throughout the inquiry

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Characteristics of a Critical Thinker
(2 of 2)
Accepts change
Empathizes
Welcomes different views and values examining issues from every angle
Knows that it is important to explore and understand positions with which they disagree
Discovers and applies meaning to what they see, hear, and read

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Approaches to Developing Critical Thinking Skills
Nursing process
Concept mapping
Journaling
Group discussions

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Nursing Process
Assessment
Diagnosis
Outcome identification
Planning
Implementation
Evaluation

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Concept Mapping
Visual representation of the relationships among concepts and ideas
Useful for summarizing information, consolidating information from different sources, thinking through complex problems, and presenting information in a format that shows an overall structure of the subject

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Journaling
Allows you to view your own thinking, reasoning, and actions.
Helps create and clarify meaning and new understandings of experiences.
When you encounter a similar situation, you should be able to recall what you did or would do differently and your reasoning.

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Journaling Suggestions
What happened?
What are the facts?
What feelings and senses surrounded the event?
What did I do?
How and what did I feel about what I did?
What was the setting?
What were the important elements of the event?
What preceded the event, and what followed it?
What should I be aware of if the event recurs?

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Group Discussions
Cooperative learning occurs when groups work together to maximize learning.
Explore alternatives.
Different scenarios of “What if?”, “What else?”, and “What then?”
Arrive at conclusions.
Connect clinical events or decisions with information obtained in the classroom.

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