Day: April 28, 2021

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Preparation for Licensure and Transition to Professional Practice

As a final post, reflect on this semester’s preparation for licensure and future professional practice. Write a thoughtful post (categorized as “Reflection”, “Licensure”, “Goal-Setting”, and “Self-Care”) guided by the following prompts:

A. How did you use your Individual Performance Profiles for each ATI Assessment to improve your outcomes (slower testing/more thorough reading of questions & answers, changed testing environment, etc.)? Include any differences you noticed as the semester progressed.

Throughout the semester, my individual performance profile for each ATI assessment varied a bit. My biggest area to work on is to go slower on my testing. I have really tried this semester to work on that and although I have made some improvement, there is still more to make. I found that taking my time has certainly improved my grades, but even when I am aware of this I still rush on certain questions individually. This is definitely an area that I am continuing to identify and improve but it is getting better. I will catch myself going a little too quick, take a deep breath, and reassure myself of how much time I have. Every exam I always have so much extra time and telling myself this information repeatedly has been helping. Another area that I have certainly improved upon is my thorough reading skills. When taking an ATI practice quiz it can “help” you and highlight or underline important terms/words of the question and this helps me understand what to focus on more. I have now taken that skill into my own hands and during exams I too highlight focus words and key information to pay attention to.

B. How did you use content gaps identified through the various ATI assessments to gain content mastery and prepare for safe practice (use of ATI remediation/content resources, review of nursing course resources, meeting with faculty/instructors, etc.)? Include any differences you noticed as the semester progressed.

I continue to be confused by the ATI remediation/content areas of review. I understand that the areas of review are from the questions that you got wrong, but when using the website when you click on the topic you got wrong, the website brings you to an area of the book that does not correlate with what the question topic is. With that being said, I utilize the search bar and find the correct information in the book myself. I often found that the ATI remediation tool in the website never really helped my understanding and I found myself looking online for the information on the given topic. I am not sure if this is considered a glitch on the website or this is how they “teach.” My favorite form of identifying content gaps is taking the quizzes that tell you immediately what you got wrong or right and the explanations they write in there are extremely beneficial. This is also the case with adaptive exams too, making the adaptive exams very beneficial too.

C. What self-care strategies did you adopt or adapt to better prepare yourself for licensure and practice (better time management, mindfulness practices, better work/life balance, etc.)? Include any differences you noticed as the semester progressed.

I certainly could continue to work on balancing life and work but I feel that this semester I really grasped a good hold on it. This semester I actually got a gym membership and scheduled in when to go and stuck to it. I found that without scheduling in my calendar “me time” I would never actually have “me time.” Putting it in there allows me to work around the “me time” and work to get things done before or plan to do things after that time. I have wonderful time management and organizational skills so that was never an issue! During my work life I hope to continue this “me time” scheduling and even try and schedule more “me time” since I will not have the burden of school work.

D. How will you use what you’ve learned and skills you’ve gained this semester to continue your preparation for licensure and transition to professional practice following graduation?

To continue my preparation for licensure and transition to the professional practice I want to always be focusing on myself and my mental health. The amount of stress and anxiety I have had throughout my nursing school career has been tremendous but I continue to find new ways to cope with it daily. The nursing profession is a high energy, high stress, profession so maintaining the focus of myself on and off the job is most important. I want to continue my education but as of right now I plan to be out of school for a few years before I go back. I am overwhelmed with joy and happiness to know that in a few months I officially will be done schooling! I have so many plans to read books, get outdoors, and join social groups without the pressure of school.

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Clinical Exemplar Narative

Once you complete any suggested revisions on your clinical exemplar, save as a pdf or Word file with a new name and upload it to a new page (page #2). Include a brief overview of the purpose of the exemplar for context, posting as an excerpt of the clinical exemplar. Although the revised clinical exemplar does not need approval before uploading, please be mindful that grammatical, spelling, and punctuation errors have been corrected, and delete all tracked changes and in-text comments (if applicable) – make sure this is something you would be proud to share with a potential employer. This must be completed by May 6th .

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Insights to Influence Practice on the Elderly

Through this course I have been able to get a much better perspective on the holistic, caring perspective, complex challenges, and unique adaptations that face aging adults. As a person in their twenties, I had not put much thought into the care and challenges that the elderly face. To have gone through four years of nursing school and wrap it up with elderly care I feel that it is a wonderful end to my nursing school career. This course took everything we have learned but portrayed the differences that are needed in an older adult. It was a good recap to go over what was learned in Adult Health and apply it but in the elderly perspective. For the elderly, the two insights I took away from this course to influence my practice going forward is to focus on the quality of life of the older individual, and drug pharmacokinetics and pharmacodynamics in older patients.

For the older adult, their care and choices are based more off their quality of life now for themselves, rather than in the younger adult, which would possibly by survival from a diagnosis for example. In the care for an older adult, the nurse wants to always be promoting the maximum independence for positive outcomes. If an older adult becomes recently diagnosed with a terminal illness, the approach for the individual should always be focused more on their comfort, based on what they choose to do for end-of-life care. It is often found that the older adult’s family members want to take control of the patient’s treatment plan, but in the end, this only causes more harm that the older adult most likely does not want. As a nurse, we want to always be advocating for our patients and in this type of situation, it is important to discuss with the family what the patient requests and to have the patient discuss their plans to their family. The older adult is more focused on the quality of life they have lived, and this often brings them joy. 

Another important aspect to reflect on from this course was the changes that took place in the older adult related to pharmacokinetics and pharmacodynamics. Nursing knowledge is essential for the special considerations of medications in the older adult population. Medications act differently in older adults and require careful dosage adjustment and monitoring. Medication adsorption in the elderly is different because systemically the older adult goes through changes such as a decreased ICF, increased gastric pH, decreased gastric blood flow and motility, and reduced CO and circulation.  The older adult has a slower metabolism can and that can slow the absorption of certain medications. With the older adult and the reduced blood flow and circulation, in the renal system this causes medications to accumulate more in the body, so the nurse needs to always be assessing medication half-lives. This is a broad discussion into the pharmacokinetics and pharmacodynamics of the older adult but it is most important for my practice going forward to understand these changes in the older adult before harm is done.

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