AACN Essentials I-IX

AACN Essentials I-IX Introduction In the beginning, nursing school was in full excitement. I was eager to learn. However, it did not take long for the excitement to turn into unrelentless stress. My perception of nursing was a dream caused by media and non-healthcare workers. Although the community believes nursing is a noble profession (and it is), there is much more to nursing then what meets the eye. It is almost as if the people stop the buck at nobility. The amount of energy, resilience, and time nurses dedicate to uphold that title is above and beyond. We are taught to be resilient. We are taught to do no harm. We are taught to provide justice. We are taught to advocate. We are taught evidence-base practice. All essentials necessary to become the nurse that the world needs us to be. The American Association of Colleges of Nursing has nine essentials of integrative learning strategies for the Baccalaureate Generalist Nursing Practice. Of these nine essentials, I believe I have been able to meet the criteria of achievement of these outcomes. Essential I: Liberation Education for Baccalaureate Generalist Nursing Practice Liberal education is the ability to except new ideas. According to the American Association of Colleges of Nursing (2009), the generalist practice for liberal education includes engaging in community-based activities to promote reasoning, advocacy, collaboration, and social justice in an ethical manner. Community-based activities include engaging in public health by volunteering or working with the community. Advocacy and collaboration include advocating for the population for equality and social justice, to not discriminate against race, gender, or socioeconomic status. During my clinical rotation at Providence Community Health, I engaged in vaccinating the local community to prevent the spread of Covid-19 and influenzae. In addition, I did community outreach which included going door to door educating the community about the effectiveness of the vaccine. We collaborated with local schools to use their facility to provide those vaccinations. The goal was to provide social justice to the communities who are least likely to have advocates and equality for all. Essential II: Basic Organizational and Systems Leadership for Quality Care and Patient Safety Time management and leadership skills are important in the nursing practice. Knowledge and skills in leadership, quality improvement, and patient safety are necessary to provide high quality health care (AACN, 2009). By possessing time management and leadership skills, these will assist in providing high quality care and patient safety. Leading staff to appropriate tasks can help the nurse manage time by being able to attend to the clients who have higher acuities. During my clinical rotation for Introduction to Med Surge, we were at the peak of Covid-19. Vaccinations were unavailable to the public. However, testing was available. I participated in covid-19 nose swab testing from a drive thru. During my rotation, each of us played a leading role in delegation and leadership. We participated in giving breaks, assigning classmates to different parts of the parking lot, work at the clinical desk, and assisting in the testing. In addition, we participated in the strategic set-up of the drive thru, educated patients on the importance of wearing a mask, how long to quarantine, and when to go the emergency room in the event they turned out positive. This taught all of us how to lead and delegate as a group for the goal of providing quality care and patient safety. Essential III: Scholarship for Evidence Based Practice Evidence-based practice is the scientific evidence of best practice. Professional nursing practice is grounded in the translation of current evidence into practice (AACN, 2009). It can help promote patient outcomes. According to Doronina et al (2017), a systemic review of hand hygiene was performed, and the results were that hand hygiene is the most effective way to prevent hospital acquired infections. Multidrug resistant organisms are common findings in hospitals. Hand hygiene is best practice to prevent these organisms from spreading to other patients. Nurse’s provide care to many different patients and touch many different surfaces on a daily basis. It is important and best practice to provide hand hygiene. This research article is a systemic review. A systemic review is a level 1 when it comes to evidence (OSHU, 2019). It includes randomized control trials with a meta-analysis. During my OB clinical rotation at Olive View Medical Center in Sylmar, hand hygiene was emphasized during orientation. We had to watch a presentation on hand hygiene and demonstrate proper hand hygiene to infection control. In addition, CHLA had emphasized on hand hygiene. We watched a video on the proper mechanics of hand hygiene. Essential IV: Information Management and Application of Patient Care Technology Patient care technology is the future of nursing. Knowledge and skills in information management and patient care technology are critical in the delivery of quality patient care (AACN, 2009). Over the years, it has changed the nursing practice. In previous years, nurses would rely heavily on their senses (Powell-Cope, Nelson, & Patterson, 2008). Due to the advancement of technology, nurses today rely on patient technology. It is important to decipher between relying on technology and using generic skills. Patient technology and generic skills are both complex yet extremely helpful. On campus at West Coast University Los Angeles, I had multiple simulations each term that included a mock electronic medical record applications and case study. The most compelling simulation was my patient who had come in for hypoglycemia. This was a group effort, so many of us were paired up with partners and collaborated on the care of the patient. We were to document each intervention given in the electronic medical record and sign the medical administration record when medications were given. In comparison to an actual EHR at the hospital, the mock EHR was very familiar. However, it has come to my attention that not all EHR are treated equally. Some are better than others. Being that I did not have much experience with the EHR, I did rely heavily on my nursing interventions that were taught in the class. Essential V: Healthcare Policy, Finance, and Regulatory Environments Healthcare policies, finance, and regulatory environments are the most pressing in the United States. Healthcare policies, including financial and regulatory, directly and indirectly influence the nature and functioning of the healthcare system and thereby are important considerations in professional nursing practice (AACN, 2009). It is the one topic I believe that inhibits best practice for nurses. It is difficult to advocate for health policy when there is such division and resistance about it. It is the one topic that I do not know how to change on a systemic level. According to the University of St. Augustine for Health Sciences (2021), health care policy is defined as the goals and decisions that determine care. In addition, it refers to the set of policies on a national level when it comes to health care costs and coverage. Until universal healthcare is an option in this country, I do not foresee any real impactful change in health policy in my lifetime. Humanity is blind in this country. During my Issues and Trends in Nursing course, some of the discussion we engaged in were issues and policies. For example, the only state that has a policy on nurse-to-patient ratios is California (American Nurses Association, n.d.). This is a direct infliction on patient safety. Nurses who are unable to properly attend to their patients are likely to make mistakes on care. It is a nurse’s duty to oversee care in a timely manner. In addition, if a nurse has high acuity patients in one shift, the level of care declines. The dangers of not having a nationwide nurse-topatient ratio are dangerous to patient safety and can ultimately cause unnecessary death. Policies need to be enacted now. Essential VI: Interprofessional Communication and Collaboration for Improving Patient Health Outcomes Communication and collaboration are important in healthcare. According to Busari, Moll, & Duits (2017), collaboration and communication of the health care team increases a collective awareness of each knowledge and skill of the nurse, physician, and other members of the health care team. It increases patient outcomes by delivering high quality and safe patient care. Communication and collaboration is a team effort. It is needed to provide positive patient outcomes. Every clinical rotation we had concept maps. Concept maps are a nursing model for planning care (Taylor & Wros, 2007). It teaches critical thinking skills and helps identify client problems that may need to be addressed through collaboration with other health care professionals. My concept maps helped me identify different aspects of care and interventions that are within my scope of practice and outside my scope of practice. Essential VII: Clinical Prevention and Population health Community health and promotion would likely decrease disease and illnesses globally. According to Healthy People 2020 (2020), clinical preventative services include screenings and immunizations to prevent disease. It reduces the population from spreading the disease or acquiring disease at a later stage through screening. Primary prevention is the intervention of education and screening. However, education is a privilege that many people globally do not have access to. It is also important to provide education to prevent disease and illness. During my clinical rotation for Providence Community Health, our class provided immunizations for Covid-19 in parts of the San Fernando Valley. Our focus was towards the lower socioeconomic communities to immunize and educate them on the prevention of disease. I believe we were successful, as there were times, we did not even get breaks due to the volume of people that showed up to these vaccination clinics. It is evident that the population was eager to learn and immunize. Essential VIII: Professionalism and Professional Values Healthcare is about values of altruism and autonomy. According to Taylor, Lynn, & Bartlett (2019), professional values include ethics and advocacy. In addition, values are formed from a lifetime of influences. Ethics is a principal that is learned from those values of right and wrong conduct, virtue, and human flourishing. Advocacy protects human rights. Combined these create professional values in nursing. Bioethics in nursing was an easy one to identify with for me. In fact, before I even learned about bioethics, I had already decided on my own autonomy, my own decision to do no harm to others, to advocate for the vulnerable, and to provide justice in ways that I knew how. By reflecting on my own values, I learned to respect other people’s choices and values. Human advocacy can be challenging especially when we do not understand their story. It took me some time to realize. Hence, my decision to become a nurse. What bigger challenge would it be for me to learn about others and the way they think? I look forward to that challenge. Essential IX: Baccalaureate Generalist Nursing Practice I am prepared to practice with patients of all populations. According to the AACN (2008), the baccalaureate graduate understands the complexity of nursing care and the need for nursing to care for patients. In addition, the baccalaureate graduate is prepared to practice with all patients, of all backgrounds, and of all populations across the globe. The level of education I have absorbed over the last two and a half years has been liberating. I believe I understand the complexities of nursing so well that I do not even know where I want to begin. I want to be part of the change and not the problem. I have been a part of communities during my rotations who have needed care. Most of them have been in the lower socioeconomic status. They have inspired me to work with them more on a global level. Conclusion This final essential is something I have been prepared for all my life. It just took me some time to get here. I cannot wait to be able to put what I have learned from my baccalaureate program to good use. I was destined to be here to embrace life and the life of others.