Running head: CLINCIAL NURSE LEADER PORTFOLIO 1 Clinical Nurse Leader Portfolio Elisha Gilbert University of California-Los Angeles
CLINICAL NUSRSE LEADER PORTFOLIO 2 The clinical nurse leader role is an innovative nursing role seeking to use evidence-based practice to not only better the current health of individuals but the healthcare system as a whole (American Association of Colleges of Nursing (AACN), 2007). Clinical nurse leaders are educated at the master s level with properties of leadership, effective communication, and critical thinking engrained into the curriculum (AACN, 2007). Clinical nurse leaders work in various settings (i.e. clinical and community based settings) alongside patients seeking to improve the quality of patient care from a primary, secondary, and tertiary perspective (AACN, 2007). Clinical nurse leaders take an interdisciplinary approach to advocating for patient care as well as population/unit based improvements to optimize patient outcomes (AACN, 2007). Clinical nurse leaders seek to identify expected risk within patient populations while also pursuing preventative measures to reduce the risk of health disparities (AACN, 2007). Equipped with openness for continuous learning, the Clinical Nurse Leader endeavors to take a collaborative approach in working with other clinicians to promote health, safety, and positive patient outcomes (AACN, 2007). Overall, the clinical nurse leader is an educator in various capacities striving for improvements in health care management and delivery (AACN, 2007). Florence Nightingale states Let whoever is in charge keep this simple question in her head (not, how can I always do this right thing myself, but) how can I provide for this right thing to be always done (Selanders & Crane, 2012)? Doing what is right and noble regardless of an individual s background is at the forefront of my philosophy of nursing care (Burkhardt & Nathaniel, 2008). Every patient deserves respect, compassion, and empathy while also being cared for in a way specifically accommodated and appropriate to their needs. Providing optimum care of patients while also alleviating discomfort is the type of care I endeavor to provide (Burkhardt & Nathaniel, 2008). Patient and family centered care is encompassed around
CLINICAL NUSRSE LEADER PORTFOLIO 3 my ability to practice nursing seeking to care for the patient as a whole. All patients should be educated on current health disparities while also being evaluated in order to alleviate potential risk and alleviate progression of disease (AACN, 2007). The role of patient advocate and effective communicator are essential to providing the most effective care for patients (AACN, 2007). Furthermore, my philosophy of nursing possesses vital characteristics essential to the care of various populations I shall serve.
CLINICAL NUSRSE LEADER PORTFOLIO 4 Core Competencies Sub-Competencies Competency or Unmet I. Health care systems 1. Use systems theory in and policy the design, delivery, and evaluation of health care. Evidence in Meeting CNL Competency N266 Coursework assignments and in class projects will assist in meeting this competency: CNL Portfolio, Clinical Case Report, Learning Communities that discuss healthcare systems and policy. Evidence of Current/Future Course Work A. N266 Health Care Systems/ Organizations ~Dates: Spring 2013 B. N267 Healthcare Policy Course Description: Analysis of healthcare policies and how policies impact clinical practice and healthcare delivery. Discussion of concepts related to policymaking, specifically how to formulate healthcare policy, how to affect political process, and stakeholder involvement in policy decision making and implementation. ~Dates: Spring 2014 C. N268 Systems (Hospital Unit): Individual Level Course Description: Discussion of use of systems theory approach in providing patient-centered and value-added care. Functioning within systems, individual healthcare practitioners learn to use critical thinking and decision making to coordinate and deliver quality and cost-effective patient care. Development of understanding of different modes of organizing nursing care within unit environment, managing care within multidisciplinary team framework, and promoting effective teamwork that enhances patient outcomes, improves staff vitality, and reduces costs. ~Dates: Fall 2013 D. N269: Quality Improvement & Population Based Quality of Practice Course Description: Principal elements related to quality improvement theories and ways in which quality management impacts delivery of patientcentered and value-driven care, including improved system performance and efficient use of fiscal resources, quality improvement, and patientpopulation quality practice at organizational level. ~Dates: Fall 2013
CLINICAL NUSRSE LEADER PORTFOLIO 5 2. Understand how health care delivery systems are organized and financed, and the effect on client care 3. Identify the economic, legal, and political factors that influence health care delivery 4. Articulate the significance of the CNL and other nursing roles to policy makers, health care providers, and consumers 5. Incorporate knowledge of cost factors in delivering care 6. Understand the effect of legal and regulatory processes on nursing practice and health care delivery N266 Week 6 lecture covered material on health care delivery systems N267 and N268 Unmet N266: ~ Currently being met. N267: ~To be met Spring 2014. N266 Week 5 Lecture E. N250 Ethical Issues, Social Justice, and History of Nursing Course Description: Interplay of social, cultural, legal, and political forces in the U.S. form background for study of ethical issues related to role of nurses as advocates for social justice in contemporary society today. Analysis situated within context of history of nursing, with emphasis on human rights, civil rights, and patient rights. ~Dates: Fall 2012 Unmet N267: To be met Spring 2014 N254B: Lecture on Legal issues of nursing. F. N254B: Theoretical Foundations of M.S.N./MECN Role and Fundamentals of Professional Nursing Lecture/Clinical Skills Practicum II Course Description: Expansion of student knowledge of practice of professional nursing as theory-based goal-directed method for assisting patients to meet basic human needs at various levels of health continuum, with emphasis on application of relevant theories to master s entry clinical nurse (MECN) practice roles in healthcare systems. ~Lecture on Legal issues of nursing. ~Dates: Winter 2013 II. Communication 7. Demonstrate communication skills during assessment, intervention, evaluation, N465A and B: this competency was met through clinical rotations in both setting G. N465A and B Foundational Concepts for Tertiary Prevention and Care of Medical- Surgical Patients and Families Course Description: Examination of nursing
CLINICAL NUSRSE LEADER PORTFOLIO 6 and teaching 8. Express oneself effectively using a variety of media in a variety of contexts in which it was pertinent that I communicate effectively through the assessment, intervention, and teaching phases with the patient population. I was also responsible for teaching patients about various disease processes and current medications. assessment and management of common health problems of adults. Theory content in basic assessment, health history, and diagnostic reasoning for selected health problems, with emphasis on social, cultural, and developmental influences. Integration of basic knowledge of pathophysiology, stress and adaptation, adult development theory, therapeutic interventions, and communication concepts as applied to care of medical and surgical patients and their families across adult lifespan. ~To be met in the future by the following coursework: 1. : Knowledge and skill assessment to promote mental health of individuals and communities. 2. : Pathophysiological and psychosocial aspects of assessment and management for selected acute and emergent problems of maternity-newborn patients, with emphasis on social, cultural, and developmental influences and integration of basic knowledge of pathophysiology, diagnostics, pharmacology, therapeutic interventions, and communication concepts as applied to care of childbearing families. 3. : Nursing assessment and management for selected acute and emergent problems in infants, children, and adolescents, with emphasis on social, cultural, and developmental influences. 4. N465D: Human Responses to Critical Illness: Pathophysiological and psychosocial concepts in acute life-limiting illness and nursing management of critically ill adults, with focus on effect of critical illness on individual and family health. N260: Secondary Prevention
CLINICAL NUSRSE LEADER PORTFOLIO 7 9. Establish and maintain effective working relationships within an interdisciplinary team 10. Communicate confidently and effectively with other health care workers both in collegial and subordinate positions Unmet This competency will be fulfilled in Winter 2014 through N467 This competency has been fulfilled through clinical rotations in N465A and B when using communication among nursing staff and clinical liaison. H. N467: Clinical Internship: Integration Course Description: Supervised practicum experience within setting of multidimensional team, with focus on application of theory in clinical interpretation of assessment and diagnostic data for purpose of planning, implementing, and evaluating course of care for patients, both as individuals and cohorts. ~To be met Winter 2014 N465A 11. Produce clear, accurate, and relevant writing N204: Research Paper: consist of a studentselected clinical problem or controversy focusing on research utilization. N266: CNL Portfolio N250: CNL Issue Brief: scholarly writing in which a written letter was addressed to unit encouraging implementation of debriefing sessions for oncology nurses. N254B: Cultural Perspective Paper: Interviewed an individual of another culture and incorporate current research in respecting patient s cultural beliefs. I. N204: Research Design and Critique Course Description: Complex research designs and analysis of multiple variables, and research utilization. Emphasis on techniques for control of variables, data analysis, and interpretation of results. Analysis in depth of interrelationship of theoretical frameworks, design, sample selection, data collection instruments, and data analysis techniques. Content discussed in terms of clinical nursing research problems and how these apply to clinical settings. Other Course Work: N204, N266, N250, N254B
CLINICAL NUSRSE LEADER PORTFOLIO 8 12. Appropriately, accurately, and effectively communicate with diverse groups and disciplines using a variety of strategies 13. Access and use data and information from a wide range of resources 14. Manage group processes to meet (team) objectives and complete team responsibilities This competency was met during clinical rotations for N654A and This competency has been met through various group assignments in courses thus far N465A N254B: Pod Lab Assignments N250: Group creative writing assignments N266: Learning Communities N252: Health Promotion/Risk Reduction Systems: Population Level. Course Description: Introduction to primary prevention strategies as they pertain to health and wellness across lifespan, using population-based approach to nursing care of diverse populations. ~Group Primary Prevention PowerPoint Presentation III. Critical Thinking 15. Engage in selfreflection and collegial dialogue about professional practice 16. Engage in creative problem solving Competency partially met through various course works thus far. Detailed group discussions took place in N266, N250, and during N465A and B post-conference after each clinical rotation. N465A and B postconference. N250, N254, N465A, N465A IV. Provider and manager of care 17. Integrate theory and research-based This competency has been partially met N254A N254B
CLINICAL NUSRSE LEADER PORTFOLIO 9 V. Nurse technology and resource management knowledge from the arts, humanities, and sciences to develop a foundation for practice 18. Demonstrate knowledge of the importance and meaning of health and illness for the patient in providing nursing care 19. Provide effective health teaching using appropriate materials, technologies, resources, and formats through course work thus far however; future coursework will facilitate more learning thus building my competency and confidence in these areas. See above response. N260: Secondary Prevention: this competency was met through an assignment using I-touch Screening Tools to use preventative measures in keeping patients healthy. N465A See above response. J. N260 Secondary Prevention Course Description: Screening and early detection of illness to prevent chronic or acutely deteriorating illness. Expanding on concepts of health and human development and using nursing process, application of nursing role in providing care to individuals and their families to screen, diagnose, and treat illness at earliest possible time to prevent disability or premature mortality. ~Date: Spring 2013 VI. Member of a profession 20. Evaluate effectiveness of health teaching by self and others 21. Understand the history, philosophy and responsibilities of the nursing profession Med-Surg 465B: Competency has been partially met during clinical rotation at Northridge Hospital was responsible for teaching patient about Deep Vein Thrombosis and preventative measures. This competency has been partially fulfilled through various coursework thus far. It will also be fulfilled N250 N254 Other: Registered Nursing Licensure
CLINICAL NUSRSE LEADER PORTFOLIO 10 22. Assume responsibility for the professional presentation of oneself once I am successful in passes the RN licensure exam. Taking responsibility for the care and promotion of autonomy of patients I was assigned to during my clinical rotations. N465A VII. Lifelong learner 23. Advocate for professional standards of practice using organizational and political processes 24. Negotiate and advocate for the role of the professional nurse as an essential member of the interdisciplinary health care team 25. Support and mentor individuals entering into the nursing profession 26. Recognize the need for lifelong learning and actively pursue new knowledge and skills as one s role and the needs of the health care system evolve Unmet Goal is to have this subcompetency fulfilled upon graduation. N467 Unmet See above response. See above response. Unmet Goal is to fulfill this as post-graduate giving back as an Alumni and seeking to teach future RN s entering the field. This competency was fully embraced while doing N266 assignment: Clinical Nurse Leader Portfolio and reading the AACN White Paper. N266
CLINICAL NUSRSE LEADER PORTFOLIO 11 Bibliography AACN (2007). White Paper on the Education and Role of the Clinical Nurse Leader. Burkhardt, M.A., & Nathaniel, A.K. (2008). Ethics and issues in contemporary nursing. Clifton Park, NY: Thomson-Delmar Learning. Selanders, L., & Crane, P., (2012). The Voice of Florence Nightingale on Advocacy. OJIN: The Online Journal of Issues in Nursing, 17(1), Manuscript 1.