A thoughtful reflective narrative no longer than two (2) pages for each BSN program outcome that validates how the three artifacts selected for each outcome helped you meet that outcome.1. Critical Thinking (paper attached below)2. Multidimensional roles for Nursing practice( copa model paper)3. Apply Knowledge (Benner’s Paper)
nur_445_critical_thinking_paper_deol.docx
nur_445_benner_s_stages_of_clinical_competence_deol.docx
nur_445_copa_model_assessment_synthesis_deol.docx
nur_445_benner_s_stages_of_clinical_competence_deol.docx
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Running head: CRITICAL THINKING
1
Critical Thinking Assignment
Arvind K Deol
Nur-445 Validating Nursing Competence
Mentor: Dr. Helms
Thomas Edison State University
01/27/2019
CRITICAL THINKING
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Critical Thinking Assignment
Critical thinking assignment is focused on helping us have a proper picture of the
meaning of critical thinking. It is worth realizing that critical thinking refers to the ability to
recognize problems as well as raise questions, collect evidence as the means to support answers
and solutions, evaluate alternative solutions, and also highly communicate effectively with others
with the sole intention to put in place or in other words implement solutions for the best possible
outcomes. Critical thinking is something that nurses do every day and also practiced by others in
their regular non-nurse life. Therefore, just as seen earlier, it is stopping, looking at a situation,
identifying a solution and choosing to try it out. The purpose of this paper is to document a
clinical experience that demonstrates my critical thinking skills and habits of the mind hence
depicting how this area is of great significance.
Clinical Experience
I had a patient who just had his leg amputated above his knee. The patient was on a
Dilaudid PCA and still complaining a lot of awful pain. He screamed out every minute, creating
the impression that he was in horrible pain. One morning, when the doctor was making her
rounds, he told her that the meds were not doing anything. The doctor added some oral opioids
and also wrote an order pointing out that it was okay for me to issue both the oral as well as PCA
dosing, with the objective of weaning off PCA.
At this point, I thought deeply of how I was going to do it. I asked the patient to describe
his pain. He stated that it felt like nerve pain, deep-burning and also tingling. He told me that the
pain meds would just knock him out and this would make him sleep for a little while only to
wake up at even what he described as worse pain. I found myself thinking about nerve pain and
CRITICAL THINKING
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other patients that do report similar cases. For instance, diabetics with neuropathy would mention
similar pain, and many of these patients were taking gabapentin on a daily basis for pain. I
decided to call the professionals concerned with surgery and asked them what their take about
trying something like gabapentin for my patient was, and this was after I explained to them his
type of pain as well as the thought process. Surprisingly, they said it was a great idea, and we
should get the patient off the opioids as soon as possible.
Upon trying gabapentin, the patient’s discomfort, as well as the pain, was significantly
reduced. He stated that I should take away the other meds supplied to him because they did not
do anything significant and issue him the nerve pain pill as it is the only thing that made a
positive impact. The patient’s pain became tolerable, and he was able to get rest.
Critical Thinking Skills and Habits of the Mind
Critical thinking is highly considered a complex phenomenon. Research revolving around
critical thinking, Rubenfeld and Scheffer (2015) helps in describing critical thinking. They
describe this topic as the objective analysis as well as an evaluation of an issue with the intention
to form a judgment. Skills of critical thinking as far as nursing is concerned is believed to
comprise of applying standards, logical reasoning, analyzing, discriminating, predicting as well
as transforming knowledge. On the other hand, Rubenfeld and Scheffer identify the various
habits of the mind of critical thinking in nursing, and these include contextual perspective,
flexibility, intellectual integrity, creativity, and inquisitiveness among others. The various
descriptors of critical thinking came about because it was believed that the student nurses lacked
the vocabulary to describe their thinking and identifying these descriptors would help them
CRITICAL THINKING
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(Rubenfeld, & Scheffer, 2015). These descriptors were of great significance in my experience
with the patient.
Critical Thinking Habits of the Mind
Confidence: My thinking based on the based solution to the challenge facing the patient was on
track and decisive and firmly believed that the approach I considered would be essential.
Contextual perspective: In my case, I was in the position to consider the whole situation and
how it was related to other similar reports and what usually happens.
Creativity: I did let my thinking to be outside the box by trying to think of other possible ways
that may perform better than the use of opioids to reduce the pain experienced by my patient.
Flexibility: I gave up on the idea given by the doctor and turned to think of a different path that
may benefit the patient (Scheffer, & Rubenfeld, 2000).
Inquisitiveness: At all times, I was eager to know by seeking knowledge as well as
understanding and this was by striving to observe and thoughtfully question other patients who
had dealt with nerves pain as the means to explore the alternative.
Intellectual integrity: Even though the doctor gave an order based on what she thought was the
solution, I had to ask myself many questions trying to figure out if there was a better approach
and with the feedback from the patient and other people, a more effective solution was
established.
Intuition: While I could not say why I thought that way, I knew that studying what the patient
was experiencing will help in establishing the best way to help him with the pain.
CRITICAL THINKING
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Open-mindedness: I did not just conclude with my finding of the use of gabapentin, but I was
receptive to new ideas and suggestions from professionals.
Perseverance: I was single-minded in my determination to find the most effective approach to
help the patient, and I knew I would get all the necessary information that will help out.
Reflection: I chose, and this assured me to keep moving on.
Critical Thinking Skills
Analyzing: As far as the whole situation was concerned, I decided to break it into parts and not
view it as just amputation done as the means to discover how it could be linked with other cases.
Applying Standards: I ensured that my decision revolved around existing professional and
social criteria
Discriminating: I was very keen to recognizing differences as well as similarities between the
case of my patient and other individuals dealing with nerves pain in order to see if what others
used could be utilized by my patient (Fero, et al., 2010).
Information seeking: My decision was supported by the evidence and facts I identified from the
sources I accessed.
Logical reasoning: My conclusion was highly supported as well as justified by evidence.
Predicting: I focused a lot on ensuring the plan or the decision I was making was going to
generate future positive consequences.
Transforming knowledge: I converted the condition, and the concepts gathered into something
of value.
CRITICAL THINKING
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Evaluation
As seen in this paper, it is evident that the interventions utilized in my experience were
highly based on prior knowledge and research. By understanding that gabapentin worked for
patients dealing with nerves pain, it helped a lot to realize that the same could help the patient
who had been amputated. My use of critical thinking was of great significance to me as it helped
me to discover how important it is to think of all the possible alternatives in any situation. Doing
so ended up providing a better dosage for the patient, and this made him more at peace.
Conclusion
It is apparent that critical thinking is of great significance as it enables one to look at a
situation and identifying a solution. Critical thinking in nursing has helped a lot of people, for
instance, it was because of critical thinking that the patient identified in this paper was issued
with a better way of dealing with his pain.
CRITICAL THINKING
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References
Fero, L. J., O’Donnell, J. M., Zullo, T. G., Dabbs, A. D., Kitutu, J., Samosky, J. T., & Hoffman,
L. A. (2010). Critical thinking skills in nursing students: comparison of simulation‐based
performance with metrics. Journal of Advanced Nursing, 66(10), 2182-2193.
Rubenfeld, M. G., & Scheffer, B. K. (2015). Critical thinking tactics for nurses. Achieving the
IOM competencies (3rd ed.). Burlington, MA: Jones & Bartlett Learning.
Scheffer, B. K., & Rubenfeld, M. G. (2000). A consensus statement on critical thinking in
nursing. Journal of Nursing Education, 39(8), 352-359.
Running Head: Benner’s stages of clinical competence
Competency Assessment Assignment: Benner’s Stages of Clinical Competence
Arvind K Deol
NUR 445 Validating Nursing Competence
Mentor: Dr. Anna Sallee
Thomas Edison State University
Feb 10th 2019
1
Benner’s stages of clinical competence
2
Introduction
Nursing entails many practices that one has to be well informed in order to thrive in nursing
practices. Basically, one has to be well versed with the nursing practices in order to have a
good time in the practice or otherwise it would be a nightmare for one who is not well
equipped in nursing whether one is a beginner or an experienced individual. Benner has
described seven domains in nursing that can be used to describe various experiences in the
practice. Specifically for this paper, I am going to consider three domains to explain my
experience in the nursing practice.
Helping Role Domain
Nursing is all about helping the patients and more so the doctors when they are
administering treatment to the patients. In nursing practice, my main objective is to help the
patients in their recovery process. Accordingly, my role as a nurse I ensure that the patients
are served with everything that is essential to their recovery process and therefore, the
helping domain is suitable in explaining my role in nursing practice. In this case, I help the
doctor by administering medications to the patients to aid their recovery process. For those
admitted in hospitals, I ensure that they are taken good care especially their meals and other
activities of daily living as well. (Benner’s Stages of Clinical Competence, n.d.)
I am an expert nurse and the helping role is what I have done daily since I began the
nursing practice.
My behavior reflects the expert level since I have garnered enough
experience over the years I have been practicing nursing as a professional nurse. (Battista ;
n.d.)
Benner’s stages of clinical competence
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The teaching or coaching domain
This is another important domain in the life of a nurse. Throughout the years I
have been practicing nursing, I have been teaching people on how they can lead healthy
lifestyles. In this exercise, I have been teaching people how they can avoid lifestyle diseases
such as diabetes and obesity. When people understand the right lifestyle measures, they can
easily avoid such diseases hence reduce the cases for diabetes and obesity. (Benner’s Stages
of Clinical Competence, n.d.)
I have extensive experience in this field of training and coaching people hence an expert.
Over the years that I have been in nursing practice, my colleagues and I have conducted
various training on healthy lifestyles and hence I am an expert in this domain. (Battista,
n.d.)The various involvements in teaching and coaching people on health-related issues have
made me an expert. We have conducted teaching in different institutions ranging from high
schools to corporate where we teach people on how to maintain healthy lifestyles.
The diagnostic or monitoring domain
After the treatment of patients by the doctors, they are left in my hands to monitor their
progress and convey their health updates to the doctors. For instance, in case the patient’s
condition is worsening after treatment I am supposed to inform the doctor so that the relevant
action can be taken. The domains put me in a position where I have to keep checking on the
patients when I am on duty to ensure they have had their meals and medications as
prescribed. Therefore, the diagnostic domain is very important to any person practicing
nursing. (Benner’s Stages of Clinical Competence, n.d.)
Over the years that I have been in the practice, I have watched over so many patients. This
has enabled me to gain the required experienced which led me to become an expert nurse
Benner’s stages of clinical competence
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since most of their needs are left on the hands of the nurse after they have been treated by the
nurse. (Battista, n.d.)
My behavior while taking care of the patients allows me to be an expert nurse, since I know
and follow strictly the directions of the doctor concerning the patients care.
Conclusion
Over the several years that I have served in the profession, I have gained the required
experience to be an expert nurse since I have undergone various circumstances repeatedly.
Reference
Benner Ch 3- The “7” Domains of Nursing Practice Flashcards | Quizlet. (n.d.)
Benner’s Stages of Clinical Competence. [Ebook] (1st ed., p. 1).
Running head: COPA MODEL
1
COPA Model Assessment Synthesis Assignment
Arvind K Deol
NUR 445 Validating Nursing Competence
Mentor: Anna Sallee
Thomas Edison State University
02/24/2019
COPA MODEL
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COPA Model Assessment Synthesis Assignment
Nursing entails many practices that one has to be well informed in order to thrive in nursing
profession. One has to be well versed with the nursing practices in order to have a good time in
the practice. As a practicing nurse, I have gone through different experiences that have taught me
on what to expect in my nursing career. The purpose of this paper is to review my reflective
thinking, critical thinking, and Benner assignments to identify the COPA Model competency and
sub skills that I met in the experiences described in my previous assignments.
Using the Reflective Process Paper
A professional experience that I found challenging was my first patient that expired
unexpectedly. This event impacted my nursing by increasing competence, intuition, and tact. It
changed the way that I react to situations and has made me a more forgiving nurse to myself. As
nurses, we learn through experiences and reflection of those experiences every day. The
important thing to do is to take these experiences, turn them into a lesson, and become a better
nurse than before.
COPA Competencies
The COPA competencies that I met in the situation above are discussed below:
Assessment and intervention skills: In dealing with the situation, I met this competency
with the subskill of assessment and monitoring. I demonstrated this subskill by ensuring I
followed the correct procedure.
Communication skills: In dealing with the situation, I met this competency with the
subskill of oral skills. I demonstrated this subskill by talking and interacting with the code team.
Since the patient had passed away, it felt like I wasted their time. I felt comfort from the other
COPA MODEL
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nurses on my floor who were supportive and helped me through, by using encouraging words
and stories of their past codes.
Critical thinking skills: In dealing with the situation, I met this competency with the
subskill of research process. I demonstrated this subskill by researching the diagnosis. My beliefs
have always been to be strong, ensuring patient safety, and satisfaction. Unfortunately this
situation did not correlate with my beliefs, but did encourage me to reinforce them in every
situation.
Human caring and relationship skills: In dealing with the situation, I met this competency
with the subskill of cooperative interpersonal relationships. I demonstrated this subskill by
interacting with the code team as well as other nurses when providing treatment options to the
patient.
Management skills: In dealing with the situation, I met this competency with the subskill
of coordination, accountability and responsibility. I demonstrated this subskill by coordinating
with the team and other practitioners in order to protect the life of the patient. I took my
accountability and responsibility as a nurse in meeting needs of the patient.
Leadership skills: In dealing with the situation, I met this competency with the subskill of
collaboration and professional accountability. I had great concern on the life of the patient and
therefore had to respond to the needs of the patient in order to provide good leadership skills for
others.
Teaching skills: In dealing with the situation, I met this competency with the subskill of
health promotion and health restoration. I demonstrated this subskill by reaching out to my nurse
manager about the situation. This situation taught me that medically emergencies happen all the
COPA MODEL
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time and death does happen in the hospital despite the care that you give. There should be a
better system for other health care professionals to know the patient’s code status.
Knowledge integration skills: In dealing with the situation, I met this competency with
the subskill of nursing and healthcare. I demonstrated this subskill by using the nursing skills in
caring for the patient in the healthcare.
Benner’s Stage of Competence
Using Benner’s criteria, I showed the proficiency of a Competent Practitioner. In dealing
with the situation I did demonstrate efficiency, had confidence and cooperated with the code
team which describes the criteria for this stage. If I had run the code for the patient, and I had a
good knowledge on how to deal with such situations like knowing how to compose myself; I
would have demonstrated behaviors consistent of an Expert Practitioner.
Critical Thinking Assignment
I had a patient who just had his leg amputated above his knee. The patient was on a
Dilaudid PCA and still complaining of a lot of pain. He screamed out every minute, creating the
impression that he was in horrible pain. One morning, when the doctor was making her rounds,
he told her that the meds were not doing anything. The doctor added some oral opioids and also
wrote an order pointing out that it was okay for me to issue both the oral as well as PCA dosing,
with the objective of weaning off PCA.
COPA Competencies
The COPA Model competencies are discussed below
Assessment and intervention skills: In dealing with the situation, I met this competency
with the subskill of safety and protection. I demonstrated this subskill by asking the patient about
COPA MODEL
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their situation. I also consulted from the professionals concerned with surgery and consulted
them about the situation.
Communication skills: In dealing with the situation, I met this competency with the
subskill oral skills. I demonstrated this subskill by taking time to talk to the patient about their
situation.
Critical thinking skills: In dealing with the situation, I met this competency with the
subskill evaluation; integrating pertinent data from multiple sources. I demonstrated this subskill
by consulting from professionals who were knowledgeable in surgery.
Human caring and relationship skills: In dealing with the situation, I met this
competency with the subskill of morals, ethics and cooperative interpersonal relationships. I
demonstrated this subskill by consulting the patients and my thinking about their current
situation. Also through the cooperation with other professionals, we were able to determine the
cause of the patient’s pain.
Management skills: In dealing with the situation, I met this competency with the subskill
of human and material resource utilization. I demonstrated this subskill by coordinating with the
professionals and also from previous cases that I had experienced before. I found myself thinking
about nerve pain and other patients that do report similar cases.
Leadership skills: In dealing with the situation, I met this competency with the subskill of
professional accountability and supporting with evidence. I demonstrated this subskill by
considering the appropriate way of approaching the patient and assessing the …
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