Category: Self-Care

Preparation for Licensure and Transition to Professional Practice

I used my individual performance profiles for each ATI when looking at specific topic areas that I needed to improve on. I also looked for areas that were below the average benchmark for each exam. In those areas I would do extra questions on U-World in those specific areas to hopefully gain more knowledge. Towards the end of the semester, I would reread my remediation sheets as well as doing the practice exams again. Another thing that I believe really helped me is reading all the rationales as I went on the practice exams. 

I used the content gaps identified through my other ATIs to further get experience with those types of questions by using U-World, Saunders NCLEX review book, and my class materials throughout junior and senior year. The differences that I have noticed is an increase in my scores by about 10 points. I think this is due to putting in the extra 1 hour a day in reviewing materials. I am happy to see that it is finally paying off. 

There really weren’t many self-care strategies that I adopted to better prepare myself. The only thing that I have been really trying to do a better job at is getting more sleep. As well as doing my practice questions in the morning when my brain is fresh. I also realized how much I want to pass this test on the first attempt and that I need to put in the extra effort now so that I can be successful and do that. Going forward I will use these skills to continue my use of U-World, Saunders NCLEX book, and my class notes to continue to prepare myself for the NCELX. I plan to do 100 questions a day throughout the month of May. My goal is to take the NCLEX as early in June as possible. I do not want to lose all that I have learned and get out of my routine. 

Attaining and Protecting Your Professional Nursing License

I plan to become licensed in the state of New Hampshire. New Hampshire is a compact state and is included in the Nurse Licensure Compact.

To register to take the NLCEX in NH all of the following needs to be included:

  • Copy of a state issued drivers license uploaded into the online application
  • Official transcriptions need to be submitted from the degree institution to nursing@oplc.nh.gov
  • RN Comparable Education Verification Form – completed by Nursing Director and sent to nursing@oplc.nh.gov
  • Criminal background check
  • Pre-register with Pearson Vue (NCLEX), https://home.pearsonvue.com

It is the responsibility of nurses and nurse managers to report all suspected abuse or impairment of any kind. Many of these nurses who are impaired or have substance abuse problems go unnoticed. It is important to recognize that healthcare workers are not immune to developing or having substance use disorder. These substance use disorders do not discriminate against who they will affect. A nurse can enter an alternative to discipline program that is designed to help get the nurse treatment, monitoring, and recovery recommendations. There are resources available, and nurses should be familiar with them as well as behavior changes, physical signs and signals of drug diversion that can help them, their peers, and patients. In April of 2019, New Hampshire developed a program to encourage self-reporting, when they do self-report, they will be referred to treatment programs and monitored through their transition to return to duty. This program is designed to treat the issue without penalty to preserve the nurse’s license. The goal of this program is to remove the stigma, provide resources for care and treatment, and keep nurses in the workforce. This program is called an alternative recovery monitoring program. 

I will protect my license from the legal issues listed above by always living by the standards and guidelines put before me. If I have a question about something I will review the process and what should be done before I do it. At first, I will also consult my preceptor or my experienced peers before being involved/doing tasks related to these issues. I understand that I cannot possibly know everything so knowing that there are resources and people out there for me to consult. I also know that having a general idea of these issues before transitioning to practice is very important because at that point I will know what is right and wrong and what involves further follow-up or action. 

Prepare for Transition

I am most excited about starting the next phase of my life. I recently solidified the job that I have been waiting for and centering my focus in nursing school around. I have finally been able to see all the pieces start to fall into place. It is nice to see that everything we are taught in school start to come together and feel like it is finally starting to get me somewhere in life. I will celebrate this accomplishment by going on a vacation with my family and friends. 

I am most anxious about having the responsibility of a nurse. I am ready for that responsibility, but I am nervous that my judgment will get clouded in times of high stress and I want to be able to make the “best” or “right” decision for my patients in those situations. I will plan my SMART goals based on a few things one being how to prepare myself to feel most confident in my abilities by working on some of my weaknesses now. I will also stay focused on the task at hand by taking it day by day and creating a schedule for myself that includes the time I need for myself for working out, friend and family time, and rest. I learned from the ATI modules how to study and schedule my time most effectively as well as the importance of good test taking habits. 

Disaster Nursing

Nurses play a large role in disaster response/management. Depending on the position of the nurse, you can be triaging, activating the response team, providing care to those who are injured, helping evacuate patients, coordinating with other healthcare officials/facilities are just a few. It goes without saying that no matter what the disaster or crisis maybe it is important for the nurse to be prepared and trained. This is why disaster trainings are so important because you never know when something may occur. Being prepared for the worst at all times is important because if you’re prepared hopefully, it won’t actually happen but in the event that it does you have the tools and knowledge to get through it. 

When determining between provisions 2 and 5 that is the constant internal battle of being a nurse. How I personally distinguish is when I am off duty or not working, I put myself first so that when I am working, I can be the best that I can be to put the patients first. When you sign up to be a nurse you know that you will never truly get a lunch break and might not pee for 10 hours and that is just the commitment that we make. You can argue that that is not right, but it is the reality, when at work the patients are the priority. I think if take care of yourself and train your body when you’re not at work that will pay off for when you are, the stronger and healthier you are the better off you will be. Nursing is almost like a sport; you must be ready for the game each shift. 

Electronic Health Records

My initial thoughts about the use of electronic health records in nursing were that it is used to document vitals, assessment findings, and medical history. I was pretty blind to the fact they can be used for so much more than just nurses and providers. With the presentation from last Wednesday, I was able to see that there are so many more people involved in the process of documenting in electronic health records and without all those various aspects involved that would not allow all the types of healthcare providers to provide the most holistic care possible. To me modern medicine seems more holistic and in my opinion, this is just another step in that direction. 

I will apply what I learned about electronic health records to enhance the care that I provide in two ways. One I will take a deeper dive into the charts of the patients that I am working with to see if there is information in there that would be beneficial for me to know in hopes to provide quality holistic care. Two I will take my documentation process more seriously knowing that this can be used to help other healthcare providers down the line, not only will this help healthcare providers but in turn make the patients care and experience better. I always knew that accurate timely documentation is important but not to the level that I do after the presentation from HIN. 

Trauma Informed Care

Trauma exposure impacts the whole person, as healthcare providers we are not only treating the patient as well as the family. The patient might have obvious physical issues, but they need to be looked at wholistically because in my opinion the psychological and spiritual welling being is almost more important. There can be long term physical ailments but if we ignore the mind and only treat the physical, we are only looking at half of the person. I will apply the trauma informed care principles in all my patient interactions. I think it is important to treat everyone the same and treat them like family. Part of this is addressing their past whether it’s good or bad. I will go into it always assuming that the patient has some form of trauma, personally I believe that everyone has some form whether small or big it doesn’t matter to that person it is a “traumatic” experience and we need to support them in a way that speaks to them the loudest. Long-term impacts of adverse childhood experiences can range from physical to emotional/mental and beyond. A few that come to mind right away are PTSD, anxiety, depression, cardiac issues, diabetes (from unhealthy eating and physical activity habits), as well as skeletal abnormalities. I think as healthcare providers this is one of the most important aspects of our care because it helps us develop trust and rapport with our patients, without trust and rapport there is a significant lack in the healing relationship. 

Public Health and Vulnerable Populations

There are many factors that influence the health of the vulnerable and marginalized populations. So many that I cannot possibly name all of them in this post. The ones that come to the front of my mind are the elderly, children who are in the “system”, and access to health insurance. People who cannot find jobs that provide them with the opportunity to have access to health insurance or the elderly/early elderly people who are on the cusp of Medicare and Medicaid. There are many factors that go into this but just in the way that we are all raised and brought up in this world sets you up for the person you will become and the opportunities you have. I feel that it also has to do a lot with your personality, there are people who are born into very privileged homes and come into adulthood with inadequate drive and skills to be a successful adult and then there are those who are thought to have no chance at surviving this world and have the most beautiful success stories. Because of this wide range I feel that it is hard to pinpoint very specific ideas as there are so many. Job opportunities, money, support systems, and upbringing are the ones that come to my mind first. 

I do not feel that we will ever be able to solve healthcare disparities as this is what makes the world go around. However, I do think that there are always ways to improve. It can be as simple as recruiting and helping people find jobs that provide health insurance. Education is huge and starts young, creating a health conscience vision that our younger population will understand and buy into will make a huge difference. Also providing support groups and systems, the first one that comes to my mind is for new first-time parents, both for moms and dads, it is a team sport. There are also ways that as healthcare providers we can help connect with our patients more by meeting them at their level and learning about where they come from and why they made the decisions they made to put them in the predicament that they are in today. There are so many ways to improve, and it is a revolving door but starting small and working our way up is the only way we can start. We can sit here and think about it and keep coming up with ideas but until people take initiative nothing will change. By taking initiative I don’t just mean the healthcare system workforce, I mean as a country as a whole, everyone needs to do their part in order to live a healthier lifestyle not just those who are providing the care. 

Wellness Reflection

My Wellness Reflection

            In order to be a successful nurse you have to take care of yourself before you can take care of your patients. This semester I made two wellness goals to improve self-care. Even though these goals may seem simple to other people, they were hard for me to achieve. It took a lot of discipline and reflection to attain them. At first, I was not remotely in the range of being able to achieve them. Nursing is more than being smart academically, it is more important to be the best you, you can be. If you cannot take care of yourself, you cannot expect to take quality care of your patients. 

My Wellness Goals

            In the beginning of the semester I came up with two wellness goals that would improve my overall self-care. While there are many goals that I could set for myself, the two that I chose were the ones that could improve my life/self-care in bigger ways. 

  1. My first goal is to recognize when my brain is done and needs a break to clear my head and then continue with studying or my other tasks for that day. 
  2. My second goal is sleep and hydration. I do not remotely get enough sleep every night. Some days I drink enough water and other days I am so far off the right amount that I could probably be considered dehydrated. In order to get enough sleep, I will make a bedtime routine for weekdays and weekends. 

These goals are important to me because in order to set myself up for success in school and support my overall immune health I needed to improve my sleeping and fluid intake habits, along with recognizing when I need to take a break from studying. When I get frustrated with studying is when I know I have gone too far and should have taken a break sooner. It is important to me that I don’t get frustrated because I will be able to retain more information and be more efficient using my time more effectively. I was successful in attaining my goal of taking more study breaks and being more efficient with my studying however, I was not successful with drinking more water and getting more sleep. While I was studying, I would set timers for 30 minutes or less depending on what I was studying. After each block of time I had to take 10 minutes and drink some water, move, or go on my phone. I tried to set timers for going to bed but that simply just did not happen. Often there are not enough hours in the day to be student athlete and get all my homework done. As for drinking enough water I would make myself drink 2 of my yetis before 12 p.m. and then 3 after 12 p.m. Being in class and not really being able to drink water and then not finding time to fill up my water bottle were the two biggest barriers in me not being able to drink enough water. 

Prochaska’s Transtheoretical Model

            Prochaska’s Transtheoretical Model is basically people’s willingness to change and readiness to commit to making those desired changes (Behavioral). My willingness to change has slowly declined throughout the semester, because at this point, I am just trying to make it through to the end. It’s sad to say but I don’t care how or what I need to do to make it through as long as my grades are good, and I am alive at the end of it. For next semester I will try to get more rest from the very beginning so that I do not start behind in that aspect of my goals. I want to implement better usage of my planner to be more efficient and effective. When applying this to patient care it is extremely important that I practice what I preach. In order to meet my goals, I will implement more timers, alarms, and better usage of my planner. I will also recognize when I am getting mentally drained. Preventing myself from being mentally over worked will be key to achieving my wellness goals. As I start to get frustrated or annoyed that will be how I know that I am in need of a break. I will also need to put timers on for my breaks because I need to get back into my work in a timely manner before I lose my motivation to actually get the work done. 

Conclusion

            Throughout the semester this class has made me more aware of my self-care habits. It has really reaffirmed the importance of taking care of myself before I can do my schoolwork and in the future be a good nurse. For next semester I will definitely be more disciplined from the start to make sure that I can be successful in achieving these goals.

Works Cited

Behavioral Change Models. (n.d.). Retrieved November 02, 2020, from https://sphweb.bumc.bu.edu/otlt/mph-modules/sb/behavioralchangetheories/behavioralchangetheories6.html

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