1. by Oluranti Efunwoye American Sentinel University

2. Career Overview  Started as a Home Health Aide (in 2006), Licensed Practical Nurse (in 2007) and Registered Nurse with ADN degree (in 2009)  Nursing career specialties are: correctional nursing, psychiatric nursing, home/public health nursing, hospital care coordination, utilization mgt, nursing informatics, quality improvement etc.  BSc in Business Info Mgt & Master of Public Health (MPH)  Received title of Certified Professional in Healthcare Quality (CPHQ) in 2014 from National Association for Healthcare Quality.  Currently working in 2 capacities – Utilization Management & Quality Improvement in a Managed Care Organization

3. Introduction  The demand for BSN as a minimum requirement for certain leadership role in healthcare has led to the pursuit of this nursing program  BSN-prepared nurses are proven to deliver improved quality patient care leading to lower mortality, fewer medication errors and other measurable quality outcomes (American Association of Colleges of Nursing, 2014)  BSN is desired at this time to derive a more synergistic effect with the previous education, training, and expertise of this author to provide a more rewarding career advancement in healthcare.

4. Leadership Role in Multidisciplinary Team Setting  Every establishment rises and falls on the quality of its leadership  The inclusion of leadership training in nursing education increases chances of success for nurse-led initiatives and also gives nursing profession a voice to establish its relevance  Leadership knowledge acquired in this program provided the skills to deliver nursing care wrapped in core leadership proficiency that thrives and stands out amidst other disciplines  Acquired ability to collaborate with Physicians in a less threatening manner, owing to renewed knowledge of leadership potential embedded in the nursing profession  Led major initiatives at work that drives departmental engagement for improved functional outcome.

5. Enhancement through Nursing Research and Evidence-Based Practice (EBP)  Nursing research and evidence-based practice are tools that provide established and proven pathway for enhancement of the nursing practice (Weiebach, Glick, Fletcher, Rowlands & Lyder, 2010)  Continuously engaging in opportunities to improve nursing practice through research-finding and evidence-based practice have helped in adopting best practice in my personal nursing practice  The separation of EBP from continuous improvement is almost impossible owing to the fact that EBP is based on a resolve to achieve better outcome, which is what continuous improvement strives for ( Nieswiadomy, 2012 )  Nursing research has made it possible to embark on a journey of nursing practice enhancement to deliver globally acceptable evidence-base practice that has records of improvement in patient outcome

6. Integration of Research Methods and Scholarship to Make and Prioritize Diagnoses  Making accurate nursing diagnoses of patient’s condition serves as bedrock of all nursing interventions and is a good predictor of patient outcome  Developing or prioritizing diagnoses should not be done arbitrarily, rather it should build on proven scholarship methods and the use of accurate research tool to arrive at a narrowed-down approach to nursing intervention  This program emphasizes the importance of using the right established nursing guidelines in assessing and developing proper diagnoses of patient’s condition  Interventions not centered on patient’s condition risks the chances of care futility, waste of resources and complication of patient’s feeble condition  Integrating research methods into diagnoses makes it possible for starting the care continuum on the platform of integrated knowledge of patient’s condition

7. Care Design and Delivery for Various Patient Populations  The notion of one-size-fit-all in nursing care does not exist in addressing the needs of various patient population  To ensure efficiency in care delivery, it is important to study each patient population using various differentiating characteristics such as: age, diagnosis, cultural or environmental need etc.  The knowledge of this differentiating attributes enables the nurse to customize care plans that meets the underlining need of the patient population he or she serves  Developing customized care delivery for various patient population maximizes the nurse’s skills, expertise and available healthcare resources in ensuring patient’s underlining care needs are met  This exercise also ensures nurse’s sensitivity to patient’s cultural needs, educational level or specific disease management requirements.

8. Health Promotion and Education in Care of Patients with Simple to Complex Needs  Understanding the level of acuity of patient’s condition is a factor to determine what health promotion or education will be suitable  As patient ages, their lifestyle demand changes with respect to their disease condition (Davies, 2011). Hence, health promotion and education also put into consideration patient’s age and current lifestyle demand  Patient’s with complex care need may require more intense health education, reinforcement and family or other support groups involvement to ensure compliance with self management plan (Casey, 2007)  Patient’s with simple care need may require intense health promotion and treatment reinforcement to prevent exacerbation of their disease condition.

9. Accountability and Responsibility for Professional Judgment and Actions  The various classroom discussions in this program provided an opportunity to learn how fellow nurses are taking responsibility for their actions in their various workplaces  Through instructor’s feedback, one is able to filter correct nursing practices in workplace from various classroom discussion and able to identify with best practices in accountable and responsible nursing practice  Self-imposed high level professionalism in accountability and responsibility has helped in becoming a better nurse with the use of professional nursing judgment  Improving on the use of professional nursing judgment through continuous education (such as this program) has also helped in understanding the trend of responsibility required of nursing professional

10. Integrate Professional Values and Role Behaviors  Professionalism is an art not learned but cultivated through personal decision and supported by environmental externalities such as organizational cultures, geographical influence, background etc.  Although, nursing profession has its own established values and role behavior, those without a bedrock of personal professional etiquette will oftentimes find it difficult to fit in and deliver professional value in their nursing practice  Workplace interactions and classroom discussions in this program have made significant impact in taking a stance and appreciating professional values and role behaviors in issues such as conflict, grievances with superiors, high volume workload etc.  In dealing with issues that directly challenges one’s professionalism, it is important to always put patient care and safety first and act in manners that is worthy of emulation by upcoming nurses.

11. Problems of Contemporary Health and Illness  Major contemporary health and illness discussed are: diabetes, obesity, communicable diseases such as HIV/AIDS and Tuberculosis  Oftentimes patient’s pre-diabetes condition go undetected and unmanaged thereby leading to full diabetes diagnosis with its full health threat and potential complications (Abraham & Fox, 2013).  Obesity is another contemporary health issue that comes with myriad of health complication and co-morbidity such as coronary artery diseases, arthritis, kidney failure etc.  Lack of health insurance, lackadaisical attitude to routine preventative check-up, socio-economic limitations are among identified causes of increase in prevalence of these contemporary health issues  Knowledge of these health and illness issue helps in assessing the nurse’s readiness and qualification to provide needed interventions to curb and manage this condition and provide better patient outcome to the affected population.

12. The Role of the Global Citizen  As global citizens, nurses are responsible for doing their part in providing community health education and promotion  The course on case management discussed the importance of understanding health coverage of the insured patient population and also available community resources for the uninsured population to ensure continuity in their care delivery  With the level of interconnectivity in today’s world, it is more important than ever for nurses to understand the illnesses and diseases common in various parts of the world to prepare to tackle these diseases should they be found on our shores  The public perceive nurses as an effective patient care authority in easing public concerns on contentious issues such as immunization due to nurse’s close proximity to the patient, hence, nurses should leverage this position to provide needful health education.

13. Shaping Health Policies through Collaborations  This program emphasizes the need for nurses to be active in discussions about health policies that affects our patients  As frontline caregivers, nurses should naturally be at advantage in providing practical inputs in shaping health policies, but must do so through effective and tactical collaborative approach  As learned in this program, career advancement through education, increase involvement in community services and at workplace are useful leverages to guarantee nurse a voice where decisions are made  Health policy making is a collaborating efforts; nurses must be well equipped with tactical approach to leverage on education and expertise in liaising with other disciplines to develop policies that yield effective patient outcome.

14. Professional Goals  Seek full time employment in the area of healthcare quality within the next 12 months  Advance healthcare quality career through more certifications such as Six Sigma Black Belt in the next 12 months. (Currently enrolled in the Six Sigma Green Belt training)  Start Doctorate in Quality Management (healthcare focus) in the next 3 years  Establish healthcare quality consulting firm in the next 5 years  Establish home health and case management firm in the next 5 years

15. Conclusion  Nurses must break the barrier of status quo and embrace the need for research finding, evidence-based practice and continuous improvement to elevate their knowledge of trending best practices in the nursing profession  With thriving technology in medicine, it should be considered that yesterday’s technical-know-how in nursing may not necessarily be sufficient to be a relevant nurse in today’s fast-pace world. Nurses must move with the tide of advancement in their specialty to avoid being labeled as obsolete  The BSN program is one step in the direction of professional development to inform nurses of current trends in the practical application of prior learning in today’s world  The conclusion of the BSN program must not be the conclusion of learning, rather it must serve as a liberation into the world of endless possibility for nurses to engage in continuous learning that insures the ongoing relevance of one’s nursing practice and the nursing profession.

16. References Abraham, T. & Fox, C. (2013). Implications of rising prediabetes prevalence. Diabetes Care,36(8):2139-2141. American Association of Colleges of Nursing. (2014). Fact sheet: Degree completion programs for registered nurses: RN to master’s degree and RN to baccalaureate programs. Retrieved from http://www.aacn.nche.edu/media- relations/fact-sheets/degree-completion-programshttp://www.aacn.nche.edu/media- relations/fact-sheets/degree-completion-programs Casey, D. (2007). Nurses’ perception, understanding, and experiences of health promotion. Journal of Clinical Nursing,16(6): 1039-1049. Davies, N. (2011). Promoting health ageing: The importance of lifestyle. Nursing Standard,25(19): 43-49. Nieswiadomy, R. (2012). Foundations of Nursing Research (6th ed.). Boston: Pearson. Weiebach, F.M., Glick, D.F., Fletcher, K., Rowlands, A. & Lyder, C.H. (2010). Nursing research and participant recruitment: organizational challenges and strategies. The Journal of Nursing Administration, 40(1):43-48.