Judgment In Nursing Practice And Education -Myassignmenthelp.Com

Question: Discuss About The Judgment In Nursing Practice And Education? Answer: Introduction The CAET ETNEP Program provides certification in the Enterostomal Therapyto the baccalaureate prepared registered nurses. The purpose of the assignment is to rate own level of competency in the practice area of Wound, Ostomy and continence using the Dreyfus/Benner Model. For each of three practice areas two learning goals will be provided that are expected to be achieved by taking the CAET ETNEP Program. The importance of this exercise prior to taking the program is also discussed. Wound In this area I would like to rate myself as advance beginner as per the Dreyfus/Benner Model. During my first experience, with my patient John, I have learnt that wound care means treating the whole patient, and not just focusing on the wound. While working with my mentor, during final year, she evaluated my skills. As per her results, I am competent in initial assessment and evaluating the wound assessment data for designing the treatment plan. However, I was not competent about interpreting different types of wound ulcers, variations in management of malignant wound and development of care plan. I was competent in guiding other nurses in wound care process. According to the Dreyfus/Benner model, a newly graduated nurse can be in this stage, aware of her legal and professional responsibility for patients but have not performed the administrative functions. At this stage a nurse will pay close attention to the performance of colleagues. However, may highly depend on the textbook accounts of patients signs and find it is difficult to measure the degree of severity and subtle variation which explains my experience (Benner, 2004)). By taking the CAET ETNEP program I would hope to achieve the competence related to- Interpreting the data related to pressure ulcer (history, wound and risk assessment) and establish a plan of care for specific ulcer Interpretation of data pertaining to malignant wound and nursing intervention related to its management Ostomy In the area of Ostomy care, I would rate myself as advance beginner, as per the Dreyfus/Benner Model. As a new graduate nurse, I am not confident completely about performing ostomy care independently. I am not student, but not even a registered nurse. During my initial years of graduation, I felt fearful of ostomy than any other surgical procedure. My experiences with mentor helped me gain intense knowledge in ostomy care. I understand the pathophysiology, anatomy of gastrointestinal system and surgical procedures associated with it. I was competent in giving personalised care and assisting in maintaining healthy active lifestyle, to one of the patient in geriatric care. He was 65 years old, with abdominoperineal resection,. I was competent in abdominal assessment, and deciding on the location of the stoma, that is easy for the patient to take care. I had learned a variety of ostomy procedure depending on the location of the disease. However, I was not competent in stoma care in different age groups as it requires different skills. According to Brykczynski (2013), Dreyfus/Benner Model, in different areas of practice a practioner may be at different levels of skills based on experience and knowledge. For instance caring for adult and young child for same illness may require different skill set. The skill model discussed by Dreyfus/Benner emphasise that more experience comes from increased grasp on particular clinical scenario, which furthers guides the nursing interactions and actions. By taking the CAET ETNEP program I would hope to achieve the following learning goals in this area- Initiate measures to mange a fistula (topical negative pressure therapy, suction, pouching system and others) Implement measures to manage and prevent peritube skin damage Continence Owing to my experience and knowledge, I would rate myself in this area as advance beginner considering the Dreyfus/Benner Model. As a new graduate nurse in this area, I am well acquainted with the general principles of continence. I can implement continence promotion and education in daily practice. I am self assured about the continence assessment. During my final year, I worked with my mentor on patient with bowel incontinence and malignancy. It was highly difficult for me to interpret data related to bowel incontinence including malignancies and fistula. However, I managed to design a care plan without help of senior nurse. I needed help of books and video tutorials for management of bowel incontinence especially antigrade colonic procedure. I was competent in researching about new nursing developments in nursing management of urinary or faecal incontinence. I failed to interpret data pertaining to urinary incontinence involving Pagets disease, in one case of male patient. According to Golnik (2014), Dreyfus/Benner Model, the centre to the logic of excellent practice, is responding about particular concern in any situation. Interventions can be better developed by clarifying the nature of the particular clinical situation. Advance beginners however, do not feel the need to look to other nurses to fulfil their responsibility. At this stage, a nurse can look for credible resources and source of information to put into use when stuck with particular clinical situation. By taking the CAET ETNEP program I would hope to achieve the following learning goals in this area- To gain competence in implementing interventions to manage urinary incontinence especially suprapubic catheterization and intermittent catheterization Manage bowel incontinences through nursing interventions such as patient training and follow up, and containment devices Importance of completing this type of exercise prior to starting the ETNEP program It is important to perform this type of exercise, prior to starting the ETNEP program to assess and document professional competencies. It is needed within the, context of changing needs in practice and education. It is important to evaluate performance, for applying the nursing knowledge effectively (Lyon, 2014). This kind of practice helps identify the areas of improvement and learning goals for future practice, as one reflects on moments from past and concrete experiences. It explains what is known and what needs to be excelled to become an expert nurse (Tranquillo Stecker, 2016). Conclusion In conclusion, Dreyfus/Benner Model is useful framework for assessing the different stages of professional growth of nurses. This model is more focused on explaining how nurses acquire the knowledge and skills required in practice. It can be concluded from personal experience that, skills acquisition is the long term process. It takes variety of clinical scenarios and engagement with patients and families. A beginner nurse is one that follows a set protocol but the expert nurse is the one who can provide most exquisite nursing care. The learning goals may help in personal transition to expert nurse, by taking the ETNEP program. References Benner, P. (2004). Using the Dreyfus model of skill acquisition to describe and interpret skill acquisition and clinical judgment in nursing practice and education.Bulletin of science, technology society,vol. 24 no. 3, pp. 188-199. doi/abs/10.1177/0270467604265061 Brykczynski, K. A. (2013). Benners philosophy in nursing practice.Nursing Theory-E-Book: Utilization Application, pp. 118. Retrieved from: https://books.google.co.in/books?hl=enlr=id=adLsAwAAQBAJoi=fndpg=PA118dq=Benner%E2%80%99s+philosophy+in+nursing+practice.+ots=qtcI_p581nsig=1YPbdmErrb5dkpiD2YJRiiCrTrk#v=onepageq=Benner%E2%80%99s%20philosophy%20in%20nursing%20practice.f=false Golnik, K. C. (2014). Assessment principles and tools.Middle East African journal of ophthalmology,vol. 21 no. 2, pp. 109. doi:10.4103/0974-9233.129746 Lyon, L. J. (2014). Development of teaching expertise viewed through the Dreyfus model of skill acquisition.Journal of the Scholarship of Teaching and Learning,vol. 15 no. 1, pp. 88-105. Retrieved from: https://doi.org/10.5860/crl12-349 Tranquillo, J., Stecker, M. (2016). Using intrinsic and extrinsic motivation in continuing professional education.Surgical neurology international,7(Suppl 7), S197. doi:10.4103/2152-7806.179231