Running head: PERSONAL NARRATIVE PORTFOLIO 1

Personal Narrative Portfolio

Name

Institutional affiliation
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Personal Narrative Portfolio

Objective 5

The current world is characterized by advancements in technologies which have

revolutionized several sectors including nursing practice. In my practice, I use several

technologies that have helped me realize efficiency in provision of care. Among the most current

technologies include tele-health and electronic record keeping. Application of technology in

practice has resulted in effective communication, reduced burnout and improved patient

outcomes. Further, tech-led services have significantly changed the way I execute my work.

Undoubtedly, utilization of technology has positively impacted my nursing practice and

contributed to maximized optimal outcomes for patients.

One of the most important technologies that I regularly use in my practice is Electronic

Health Recording system (EHRs). The ability to store data and access crucial information

regarding patients and care delivery is a significant milestone in increased effectiveness at work.

Through EHRs, I can comfortably format information about patients and share across networks.

Furthermore, this system enables tracking treatment and care progress as well as patient

outcomes (Akhu‐Zaheya, Al‐Maaitah & Bany Hani, 2018). I also send and receive orders,

healthcare results and reports through EHRs. The system is beneficial in practice since it

enhances effective decision making as well as delivery of evidence-based practice.

Use of Technology

Use of technology in my nursing practice has been useful in meeting needs of diverse

populations. New technologies are associated with decreased human as well as positive impact

on care. According to Piscotty Jr, Kalisch and Gracey‐Thomas (2015), use of technology in

nursing practice is associated with fewer risks of making mistakes that may impact negatively on
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patient outcomes. For instance, when electronic records are used, patient information can be

effectively store reducing risks of loss of data. At the bedside practices, there is reduced

possibility of medical errors when the appropriate technologies are used.

Advancement in tele-health has critically enhanced accessibility. By using this

technology, I have been able to remotely monitor patients without having to physically be with

them. Use of mobile health apps and live conferencing with patients has made it possible to serve

various clients at ago; hence, making care delivery faster and efficient. Therefore,

telecommunication systems have contributed to optimized patient outcomes.

In addition, application of technology in nursing practice is associated with increased

patient safety, reduced hospital stay and improved performance. For instance, Used of EHRs

promotes safer environment by increasing accessibility to real-time information. Efficient care

coordination in my nursing practice has also enhanced performance, comfort and reduced time of

stay in the hospital for patients.

Future Plans

As technology continues to evolve, I plan to continually align myself with these

advancements. Markedly, living in a dynamic world where new technologies are emerging

everyday requires a nursing professional to stay updated. In this regard, I plan to intensify my

efforts in research and evidence-based patient care. By keeping up with the available

technologies, I would succeed in provision of patient-centered and contemporary care.

Furthermore, I am committed to life-long learning to integrate current knowledge in nursing

practice. By so doing, I am confident of sharpening my skills in critical thinking, creative

innovations and problem-solving. The dynamic nature of modern diseases and patients’ needs

demands critical thinking. Therefore, developing innovative mind combined with proficiency in
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application of current technologies in nursing practice would substantively enhance positive

patient outcomes.

Objective 6

In my nursing practice, I seek to excel in provision of patient-centered care, engaging in

goal oriented tasks and evidence-based practice. To increase effectiveness in discharging my

duties to clients, I engage my patients in the whole care planning (Robinson et al., 2008). Firstly,

I assess the patient and collect data from them and their families so as to understand their needs

and risk factors. Secondly, using data and feedback, I carry out nursing diagnosis to establish

their problem and best approaches. Further, I appreciate the important of short-term and long-

term planning in bid to holistically meet the patient’s needs. The patient and their family’s input

at this stage are important in provision of need-sensitive care. Thereafter, I develop a care plan

based on the patient’s health conditions and results of the nursing diagnoses. To ensure optimal

patient outcomes, I have to closely monitor the patient’s progress and modify the process

whenever necessary.

Patient Involvement in Care Plan

Patient involvement in decision-making is important since they effectively understand the

kind of care being offered to them and prevents possible readmission. In practice, I involve

patients in care development by, first, carrying out patient education considering most patient

have little or no knowledge regarding diseases and treatment and care options. To do so, I use

both verbal and written communication and empower them to feel as partners in their care. Some

of the most important information I pass to them includes diagnosis results, care options,

medication and self-care. Secondly, I encourage patients to seek clarification and ask question

whenever they fail to understand something. To facilitate inquiry for patients that are afraid of
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asking questions directly, I provide them with a writing material together with the patient guide.

Thirdly, I foster feedback from patients regarding their medical progress and other crucial

information. This could be done whenever I visit, via mail or phone. Patient satisfaction is my

ultimate goal in nursing practice.

Incorporation of Holistic Care Concepts

Nurses and patients must partner in care so as to enhance holistic care. According to

Jasemi et al. (2017), holistic care is built upon mutual understanding of patient’s physical,

emotional, psychological and spiritual needs. To meet the physical needs of patients, I use

observation and asking questions to assess their extent of pain. Further, I strive to sympathize

with patients and provide emotional support to them and their families. The main goal is to

understand the needs of my patients and try to resolve them.

Incorporation of Evidence-based Practice Guidelines

To incorporate evidence-based practice, I seek to make decisions based on my

professional knowledge and skills as well as patient input and their desired design of care. The

appropriate intervention for the patient’s condition is arrived to by synthesizing evidence and

understanding the patient’s needs (Kleinpell & Gawlinski, 2005). Undoubtedly incorporation of

evidence from credible studies, patient’s values, beliefs and preferences and my clinical expertise

contributed to informed decision-making and in turn positive patient outcomes.

Case Study

Based on my case study, I aim at ensuring holistic care assessment and pathophysiology

patient diagnosis. In this regard, the main types of diagnosis used are problem-focused diagnosis,

risk nursing diagnosis and health promotion diagnosis (Vera, 2020). Consistently, I intend to

effectively define the case, assess potential risk factors and work towards promotion of health to
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not only the patients but also their families and communities. Indeed, integration of these three

types of diagnoses would enable me to be effective in nursing intervention.

Objective 7

Integration of traditional and complementary healthcare practices aims at addressing the

wholesome health needs of human beings. According to Ross (2009), integral health care

recognizes that human beings have needs related to their physical, emotional, spiritual and

mental dimensions, which ought to be, met during diagnoses and treatment processes. In this

regard, nurses do not seek to address the physical needs of their patients but also ensure they

support them mentally, spiritually and emotionally. To accurately intervene in the patient’s

conditions, nurses learn to integrate both traditional and complementary healthcare practices in

the process of care provision. As a nurse, I also incorporate complementary therapies in my

nursing practice.

Integration of Complementary Therapies in my Nursing Practice

There is a widespread use of complementary and alternative therapies in healthcare

across the globe. In my practice I also apply complementary therapies to ensure provision of high

quality care to patients. Notably, complementary therapies are used alongside conventional

healthcare practices to provide the natural touch of care to the patient as part of holistic care

practices (Jong et al., 2012). Some of the complementary therapies that I frequently use include

dietary supplements, massage therapy, activities for strengthening mind and body such as yoga,

probiotics and others. While some of these therapies have been tested and studied, others have

not. Undeniably, when used in nursing practice, these therapies produce positive patient

outcomes.
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In the attempt to provide patient-centered-care, application of these therapies in my

nursing practice is always accompanied by consent from the patient. Firstly, I provide patient

education to the patient and their families regarding use of complementary therapies; the kind of

needs they meet, how they are done and their side-effects. Oftentimes, patients have prior

knowledge about these therapies and are willing to apply them in care. For instance, most

patients that I have provided care to during my one year of practice have acknowledged the

importance of dietary therapies and found it easy to integrate them in care. That said, these

therapies assist patients in the process of recovery.

Working with Patients that Practice Complementary Therapies

In my nursing practice, I work with patients that use complementary therapies by

ensuring optimal participation of the patient and their families. Firstly, I engage in research and

evidence-based practice so as to understand all aspects about these therapies: costs, drug

interactions, patient knowledge and side-effects. As a nurse whose primary commitment is to my

patients, I educate, provide advice and care to my patient with these therapies. According to

Kwai Ping (2015), the therapeutic approach used when integrating complementary therapies

aims at provision of holistic care through maximum involvement of the patient in the whole

process. This author, further, contends that, increased knowledge by the nurse and awareness by

the patient regarding complementary therapies contribute to evidence-based practice that leads to

positive patient outcomes. Therefore, in my practice, I ensure am knowledgeable and transfer

same knowledge to the patient.

When integrated in conventional healthcare practices, complementary methods have

critically helped my patients to quickly progress to independence. I have a positive attitude

toward complementary therapies having applied them in my practice and ascertained their
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impacts on the process of healing. Therefore, incorporating complementary therapies in nursing

practice is beneficial, requires knowledge, cooperation between parties and crucial element of

achieving holistic health care.

Objective 8

Outcome measures are crucially used to assess the impact of care provided to the patient

in terms of meeting their health needs and hastening the process of recovery. According to

WHO, outcome measures are “the change in the health of an individual, group of people, or

population that is attributable to an intervention or series of interventions” (WHO, n.d). Some of

the most significant outcome measures that I have used to asses impact of care in my nursing

practice include patient experience, mortality and readmission among others. I have also used

these components as informers for the need to improve care by abandoning some practices and

adopting new. Indeed, outcome measures have been useful in my nursing practice.

Using Safety and Quality Improvement Strategies

In practice, I have used several healthcare quality and safety improvement measures to

warrant provision of competent services to my clients. Firstly, I critically analyze data and

patient outcomes so as to make necessary improvements that would produce positive outcomes.

In this regard, I have to primarily establish the existing opportunities for improvement using

health records, research findings and other data sources. Secondly, my main aim is to provide

patient-centered care, avoid injuries to patients, reduce waste and offer timely services to my

clients. Thirdly, I apply the Plan-Do-Study-Act (PDSA) model whereby I plan the change to be

implemented, put it in practice and observe results, study the outcomes and the adopt, drop or

repeat the process (Gillam & Siriwardena, 2013). In this regard, I am always guided by the

outcome measures so as to guarantee quality and safe healthcare services to clients.

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Quality and Cost of Care

Considering the importance of cost management for care and inability by many citizens

to pay for hefty medical bills, it is important for me to optimize the quality of care while

maintaining it at low cost. Use of cost measures in this case has been paramount. This includes

cost optimization by using various approaches such as reducing waste, provision of high-

intensity care and others. Vogeli et al. (2007) contends that, avoidance of unnecessary

procedures and tests that are non-beneficial or do not yield notable changes is milestone toward

optimizing cost of care and maintaining high quality. Consistently, using my professional

judgment, I determine the test that need to be done and those that do not based on their

importance. Undoubtedly, this has resulted in positive outcomes despite being cost-effective

care.

Besides, I engage in more research to ensure effectiveness in every process while

reducing the degree of uncertainty in practice. Indeed, ensuring that one is effective in their

practice is both time and cost effective. Jha et al. (2008) argues that, high-quality medical care

decisions made in practice yield immeasurable benefits to patients in addition to being

affordable. Therefore, my nursing practice is mainly dictated by the need for high quality yet

cost effective practices.

Case Study

Based on my case study, I have developed several outcomes to address various nursing

diagnoses and their effectiveness. For instance, I developed outcomes indicators to assess

effectiveness of problem-focused diagnosis. In this case, the problem is clearly defined; say a

patient is suffering from diabetes. By assessing progress, measuring their BP and blood sugar
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levels regularly would inform on the impacts of care administered. Therefore, outcome indicators

are efficient measures for impact of care.

Objective 9

Using Case Management Principles in Coordination of Healthcare

Case management aims at treating each case uniquely and appropriately managing,

efficiently providing and executing care. In my nursing practice, I encounter different type of

patients with diverse needs. Therefore each case requires a unique approach at all stages of

management: screening, assessing, risk identification, planning, implementation, follow up and

evaluation. According to Gursansky, Kennedy and Harvey (2020), effective case management

entails focusing on improving the patient’s health and enhancing wellbeing through

communication, education, and advocacy, allocation of resources and facilitation of all services.

Markedly, case management is guided by several principles, beneficence, autonomy, justice and

maleficence. As a nurse am guided by these principles in provision of patient-centered care and

focus on achieving quality outcomes.

Consistent with nursing code of ethics, my main focus is the meeting needs of my patient

in the most efficient, equitable and safe way. To do so, I highly esteem the patient and family’s

cultural beliefs, values and needs. For instance, some cultures such as Chinese have strong

beliefs on the effectiveness of traditional medicine over modern western medicine (Wu, Burke

and LeBaron, 2007). Therefore, when I am providing care to an individual from that culture, am

always sensitive to their culturally held beliefs and seeks to provide substantive patient

education. Furthermore, I acknowledge my limitation to knowledge and work collaboratively

with others. By so doing, I have realized efficiency in the provision of nursing care.

Age Groups of Patients with Which I Work

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In the course of my work, I meet patients of different age groups i.e. pre-school (3 to 5),

school age (6 to 12), adolescent (13 to 18), adult (19 to 65) and elderly (over 65). Markedly,

most of my patients are middle aged adults and the elderly. In seeking to provide comprehensive

and high quality care, I acknowledge that each patient group has their own unique needs and

considerations that ought to be incorporated in care planning and implementation. For instance,

most elderly people have many underlying issues including a series of losses which they also

grieve. These may include loss of their physical capabilities, memory, spouses, loss of

independence of functions and others (Wagner and Bear, 2009). These losses are not common

with other younger age groups. Thus, I treat each age group differently since their needs are

unique.

Working with Patients and their Significant others

Oftentimes patients are accompanied to the clinic where I work by close people such as

family members, workmates and/or friends. These people are crucial in care planning. For

instance, I encountered a patient that had gotten injured at the work place and was accompanied

by workmates. The patient had lost consciousness and could not talk. Therefore, I had to depend

on information provided by the workmates for nursing diagnosis and recording. In other

instance, a mute patient was brought to the clinic and I had to rely on family members to provide

crucial information about him.

Participation in Case management

In my nursing practice, I have participated in case management in several ways including

collaboration and partnership. This has been done through consultations and working with

colleagues so as to pool knowledge and resources with the core purpose of providing high

quality services to our clients in the clinic. Furthermore, I have had efficient collaboration with
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individuals, families and community where I work in bid to assess their needs and specifically

design care and patient education to meet those needs. Indeed, my participations in case manage

have been effective.

Objective 10

State Board Regulations on Delegation and Supervision by Professional Nurse

According to Minnesota State Board of Nursing, making of decisions to delegate or

assign other duties and activities to nurses require nursing judgment. The delegation process

begins at the administrative level whereby organizations and staff oversee the process by giving

responsibility. In this case, it involves empowering staff from all levels and healthcare setting.

According to the provisions of the department, the employer, nurse leaders, the delegate and the

individual licensed nurses all have duties and responsibilities in the delegation process. However,

the administration maintains the power to supervise, delegate and oversee all the requirements of

the law. [Minnesota State Board of Nursing, n.d]

Instance of Delegation in My nursing Practice

During my nursing practice I have had numerous instances where I delegated

responsibilities to other members of the team. For instance, last month I took a day off to attend

to some family matters. Coincidentally, I was supposed to attend to a patient the same day.

Therefore, I delegated to a fellow nurse to attend to that patient. According to Potter, Deshields

and Kuhrik (2010), there are five most critical rights of delegation of duties in nursing practice:

right task, right person, right circumstances, right direction and communication. Furthermore, it

is considered more preferable to delegate duties to a licensed practical nurse. When assigning my

fellow nurse these roles, I ensure that I complied with these rights. To assure quality of care was

still administered to the patient in my absence, I provided the fellow nurse with nursing care
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records for the patient, where she would know the progress and other elements essential for

provision of care to that patient. After returning to work, she gave a report that showed the work

that was done.

Instance of Supervising in my Nursing Practice

Having been in the practice for one year, I also received supervisory role from another

member of the nursing team. In this instance, I was assigned the duty of scheduling activities in

the clinic, overseeing other nurses as they undertake their duties and ensuring efficiency of work

in the department. To execute these responsibility I met the team of nurses in the morning to

assign patients, emphasize on adherence to all nursing standards, policies and procedure as well

as maintaining high quality nursing documentation, from where I would write my report at the

end of the day. In addition, I was active in monitoring all the activities undertaken by my team.

Professional Nursing Standards

Professional nursing standards describe the competence level as well as performance of

nurses in their professional work. Their main purpose is to ensure that nurses function in a safe

and competent manner that safeguards safety and health of patients (Masters, 2018). Further,

these standards are used by employers and nurse leaders to determine unsafe work habits and

address them as well as comparison of practice among nurses and teams. To incorporate these

nursing standards in my practice, I ensure that U follow nurses guideline, code of conduct and

other requirements for the nursing practice. I always remain responsible in my work and

accountable to my seniors. By so doing, I developed efficiency in execution of my duties as a

nurse.

Objective 11

Working with Interdisciplinary Health Care Teams

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In my nursing practice, I work with teams of healthcare professionals with different

expertise with the sole aim of meeting the goals of my clients. Thus, I acknowledge the

importance of collaboration within the healthcare system. According to Leipzig et al. (2002),

nurses assess and reassess the needs of their clients and work through the continuum of care so

as to communicate with other important disciplines. In my nursing practice, I encounter patient

with different conditions; some that are beyond my scope of training. In such instances, I involve

other members that are experts in those fields who assist me in executing the work.

How Interdisciplinary Teams collaborate in care Provision

As a nurse, collaboration with others in nursing care practice is done on the bases of

mutual and collegial respect. To ensure all the appropriate members are incorporated in care, I

must work with the patient, their families, other nurses and healthcare provides. Cashman et al.

(2004), asserts, that no one has the exclusive possession of knowledge in healthcare and thus,

involvement of interdisciplinary teams aims at achieving optimal quality of care to the patients.

Further, to enhance effectiveness and become a credible collaborator, I include exemplary

communication and interpersonal skills, critical thinking skills, respect for others, problem-

solving skills, establishing and maintaining trust as well as employing sharp decision making

skills. The ability to understand where and how other members of the multidisciplinary teams

will participate is crucial for improved patient care and as a collaborator and nursing leader.

Roles of Each Member in the Interdisciplinary Team

To enhance division of work and collaboration, each member in my nursing team has a

distinct role in line with their scope of practice. For instance, nursing assistants provide direct

and indirect care to patients through assisting other personnel in the practice. Licensed Practical

Nurses (LPNs) work under my supervision and as registered nurses theirs is to perform both
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sterile and non-sterile procedures in care. Besides, I involve other registered nurses at an equal

level in my nursing practice. Medical doctors are also members of my multidisciplinary team

whose role is to provide medical care by performing roles in their practice such as nephrology,

psychiatry, dermatology and others.

Experiences in my Nursing Practice

In my nursing practice, I encounter different cases that need unique approaches. Some of

these cases result in ambiguity and uncertainty and I must apply critical thinking skills to

deconstruct them. For instance, I once encountered a patient with high arterial blood gases and

oxygen saturation levels. The family was afraid that they might lose their loved one and with

lack of knowledge on distribution of roles in health care system, they begged me to offer any

assistance to the patient. Since this was not in my scope of practice, I worked collaboratively

with respiratory therapists. Markedly, I would report the patient’s psychological and emotional

status as well as vital signs after diagnostic tests and medication to the expert. The expert nurses

would then advice accordingly on the best courses of action. Therefore, as a collaborator and a

nurse leader, I must ensure that all the necessary disciplines in the multi-disciplinary teams are

fully involved and contribute maximally to the plan and implementation of care so as to achieve

the expected patient outcomes. The case was effectively managed as both the patient and their

family were satisfied with care provided, which also had positive patient outcomes.

Objective 12

Life Long Learning and Professional Career Development

Life-long learning is an essential element for development of the right skills and

experiences for my nursing practice. According to Fischer (2000), life-long learning entail self-

initiating education with the aim of personal development and professional reasons. It is an
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ongoing process with voluntary and intrinsic motivations for self-sustainability, employability

and competitiveness at work. In nursing practice, life-long learning has been recognized as a

necessity which every success-oriented nurse like I must engage in. Therefore, development of

learning skills is an essential element for intellectual and practice independence.

Learning from others

One of the most profound ways of advancing lifelong learning and developing efficiency

is my nursing practice is interaction with others. In my nursing practice, I interact with diverse

people from where I learn numerous things. These include patients, families, caregivers,

colleague nurses and other health care providers, government official and others. For instance,

interaction with patients enhances crucial communication and technical skills as well as the

ability to understand various problems and provide the most appropriate solution. Furthermore,

collaboration with nurses and other healthcare providers enhances relationship building and

learning from one other, which is salient in sharpening my nursing skills. Belongingness and

apathy are major contributors to positive self-directed learning and brings about satisfaction in

the learner.

Besides physical interaction with others, I engage in research thinking with the aim of

honing crucial skills in my practice that would enhance effectiveness. According to Logemann

(2007), research thinking entails continued brain activity, inquiry, exploration skills,

reinforcement of curiosity, observational learning and involvement in research-based learning to

search for knowledge and skills necessary for practice. Therefore, in my nursing practice, I am

curious to question every aspect of my practice and engage in exploration so as to gain the right

information and knowledge necessary for my nursing practice. Although I expect new
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possibilities, the ability to learn and add more skills to my nursing practice is a crucial element in

life-long learning.

Personal Development

As a nurse, personal development is the ultimate goal of practice as I want to realize

effectiveness in the way I respond to cases, interact with stakeholders in care provision and work

toward building strong person. Personal development is a lifelong process, which enables people

to assess their skills and quality in addition to critical goals and aims in life that enhances

practice (Fuller & Unwin, 2004). Notably, the Maslow’s hierarchy of needs proposes innate need

for personal development and growth among individuals. As a nurse, I am motivated towards

self-actualization and achievement of full potential in practice. Goal setting is an important step

in the quest for personal development. To do so, I have developed the habit of setting long-term

as well as short-term goals so as to remain defined on what I want to achieve. Therefore, am

keen to develop key personal skills that would significantly contribute to effectiveness in my

nursing practice.

Self-compassion and mentorship are also other essential elements of personal

development. While I expect obstacles and set-backs in my nursing, I prepare myself to respond

to them effectively through increased self-improvement motivation. Consistently, I always

ensure that I confront my mistakes and weaknesses and determination to become a better nurse.

Furthermore, I have a number of mentors who guide, correct and help me improve in my nursing

practice. Undoubtedly, good mentorship relationships results in career success, increased access

to opportunities and ultimate career development.

Objective 13

Professional, Personal and Benedictine Values in Nursing Practice

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Owing to the dynamic nature of patient needs and the importance of patient-centered

practice in contemporary nursing practice, I work toward incorporation of all personal,

professional Benedictine values in my practice. In the current practice, nurses are required to

possess crucial knowledge and skills and be aware of professional values and standards required

for provision of high quality and safe care (Gallagher, 2004). Therefore, engaging in programs

and activities that promote comprehension of critical professional values and increased nursing

awareness is important for the realization of effectiveness in one’s professional practice.

Furthermore, motivation for personal development and incorporation of all important values in

nursing practice is a salient component for realizing success. Therefore, I am always motivated

to incorporate the most salient personal and professional nursing values so as to achieve positive

patient outcomes.

In my nursing practice, I work towards development and integration of personal values

so as to enhance service provision. According to Gallagher (2004), personal values are

internalized from the community, society or culture whereby one lives. Therefore, these values

are enhanced through the feelings of acceptability, sense of belonging as well as the sense of

individuality. Some of the most crucial personal values are cognitive, affective and behavioral.

Markedly, I acknowledge that beliefs and worldviews owned by myself is different from that of

others. Therefore, I try so much to incorporate them in my nursing. Other values such as being

kind, honest and compassionate has critically defined my one year of nursing practice.

Furthermore, I affectively treat all clients with respect and at the same time acknowledge their

autonomy as partners in care. I also adjust my behaviors to reflect professionalism so as to attract

trust for the healthcare systems from clients. Therefore, I hold highly to personal values as

crucial elements of success in my nursing practice.

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Besides, my nursing practice is encircled by incorporation of professional values so as to

warrant growth as a nurse as well as provide effective and high quality care beyond reproach and

that which contributes to positive patient outcomes. Some of the crucial nursing values that I

learned in school and those that I have acquired in my nursing practice include code of ethics for

nurses, the tenets of nursing practice, framework for standard nursing practice and evaluation as

well as nursing teaching and efficient interaction with peers. To increase application of these

values in practice, I have significantly made the habit of reading the list of values everyday

immediately after arriving at the workplace, visualizing and planning how I would apply them in

my day’s work.

The fact that nurses receive a number of patients with distinct values and needs implies

that they should remain sensitive to patient’s needs and values. Application of Benedictine

values in my nursing practice is one of the most significant ways of doing so. Some of these

values that are salient to my practice include awareness of God and different religious faiths and

views held by individuals, establishing relationships in communities where I live, ensuring

justice, equal treatment of all and striving for peace with others (Jezuit et al., 2018). Therefore, I

have been able to show respect for patients, effectively collaborate with others and provide

physical, emotional and spiritually sensitive care to my clients. By so doing, I have significantly

realized effectiveness in care delivery and contributed to patient satisfaction.

Objective 14

Managing Change, Ambiguity and Uncertainty in Nursing Practice

The complex nature of healthcare systems and unpredictability of patient’s needs and

demands necessitates preparedness to deal with uncertainties. According to Garg and Deodhar

(2012), uncertainty in nursing may be caused by unfamiliarity with medication, struggling to

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meet workloads and beat deadlines as well as the complex process of adjusting workflows so as

to incorporate critical changes in documentation and other requirements in care delivery. As a

nurse I have severally had incidences of uncertainty and ambiguity in my practice. Most of the

times, I have responded and coped with the uncertainty by seeking assistance from colleagues

and expanding my scope of knowledge by using credible resources and theory. For instance, the

nursing theory has been a crucial tool for me when responding to uncertainty.

Furthermore, I have encountered a number of uncertainties related to the experiences of

changing conditions related to pre-planned patients’ conditions as well as frequent shifts in

changes and patient’s needs that require high levels of care. While there is a common belief that

chaos and instability exist in other arms in the hospital, as a nurse, I have also encountered

chaotic moments that needs fast and efficient response (Garg and Deodhar, 2012). In those cases,

the ability to consolidate knowledge and work towards achievement of stability is a critical

success factor. Confidently, I have effectively managed most of the instances of uncertainty and

ambiguity that I have encountered in my nursing practice.

An Example of Recent Uncertainty and Ambiguity in Nursing Practice

One of the most critical uncertainties in my nursing practice relates to decision-making

during patient assessments, nursing knowledge, intentions and interventions for care. For

instance, I encountered a patient that was extremely concerned about nurse-patient power

distance and would provide adequate information to warrant effective handling of the situation

and care provision. Exposure of diverse patient needs resulted in significant uncertainties in

planning and implementation of care, which posed huge challenges in decision-making. To

effectively respond to this uncertainty, I involved co-workers and sought for more knowledge

from credible sources including recent research so as to provide evidence-based research in the
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matter. Ultimately, the issue was solved amicably resulting in provision of evidence-based

competent care that positively impacted on patient outcomes.

While the situation was challenging, it made me feel more obligated to my nursing

practice including how I to build nurse-patient relationships as well as responding to difficult

situations in my practice. Undoubtedly drawing on multiple sources and integrating

intersubjectivity, working towards patient-centered contributed to increased effectiveness in

response as well as decision-making. Furthermore, it was paramount to implement research-

based practice so as to reduce future uncertainties and ambiguities. Therefore, a comprehensive

understanding of uncertainty as well as incorporation of the appropriate knowledge was

substantive in effectively responding to the above described case. Management of this case

indicates that I have acquired critical skills relevant for effective management of uncertainty and

sufficient to address issues in clinical practice.

Dealing with Change

Coping with change and uncertainty is difficult and requires effective response and

management of the situation. To effectively manage uncertainties and ambiguity, as a nurse, I

had to develop a mechanism for reducing stress associated with it and embracing the change

(Schmidt et al., 2004). I am always willing to move away from resistance and develop positive

thinking as well as ensuring effective communication with all parties involved in care.

Undoubtedly, I have realized success due to effective response to uncertainty and ambiguity.

Objective 15

Employing Creativity in Nursing Practice

Creativity has been an important element in my nursing practice. According to Ruggiero

V and Ruggerio R (2004), creative thinking entails the ability to consider things and bring new
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perspectives. Considering the complexity of healthcare and the dynamic nature of patient needs it

has been important for me to employ creativity and create innovative ways of problem-solving.

Fasnacht (2003) contends that, nurses that effectively integrate creativity in patient-centered care

are better placed to provide high quality care and significantly reduce costs in the healthcare

systems. Therefore, application of creative thinking in my nursing practice has positively

impacted patient outcomes and increased patient satisfaction.

Situation that Required Creative Thinking in my Nursing Practice

As a nurse, creative thinking is something that I apply every day at my workplace. One of

the most memorable moments where I applied creative thinking is a day where my patient’s leg

had just been amputated and I was supposed to provide care to her and offer moral support to her

and the family. She was in horrible distress and complained of awful pain. The doctor had

prescribed some medicine which did not seem to relieve pain. He added opioids and gave both

oral and PCA dosing. However, the patient kept complaining of sharp pain. When I asked her to

describe the pain, she noted that she had nerve pain that was deeply burning and tingling within

her. Regularly, the pain would make her unconscious or even knock her out. She remained at the

end of her rope.

To provide as solution to this patient, I thought about the pain and how similar conditions

were addressed in the past. After a critically thinking through the problem, I remembered that

patients with diabetic neuropathy could be treated by gabapentin to relieve pain. So I was

confident that it could work for the patient. Thus, I embarked on preparing to administer

gabapentin with the help of an assistant nurse. Markedly after administration of this medicine,

pain and discomfort was substantively reduced. By giving the nerve pain pill it worked greatly
PERSONAL NARRATIVE PORTFOLIO 23

and helped the patient to recover. Therefore, creative thinking in the case helped me to

effectively address the situation and enhance positive patient outcome.

Utilizing Creative Thinking to Enable Change at the Workplace

Considering the fast-changing and dynamic nature of healthcare processes, it is important

for healthcare systems to encourage creative thinking and development of innovative solutions.

To do so in my nursing practice, I would attempt to collaboratively work with others in my team

and critically think through problems so as to provide the most appropriate solutions. Markedly,

collaborations enhanced shared vision whereby members can respond to problems and provide

working solutions (Fasnacht, 2003). Thus, collaboratively working with other healthcare

providers would essentially enhance care provision. In all instances that I applied creative

thinking, there has been positive patient outcomes and increased patient satisfaction.

I feel comfortable with the use of creative thinking in nursing practice since it is

associated with positive outcomes. To increase use of creative nurses should engage in a

systematic way of problem identification and development of solutions. To do so, nurses ought

to, first, identify and assess the problem or patient needs. Secondly, they should refer to sources

and creatively think through the problem so as to provide the best course of action. Further, a

plan ought to be developed on how the proposed solution would be implemented. By following a

systematic way of problems solving nurses would substantively proceed towards effectiveness in

nursing practice.
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