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My name is Krista. I was born and raised in Florida. I grew up being surrounded by so many influential people. My mom was a pediatric oncology nurse and my father was a combat medic in the United States Army, my grandmother was a nurse for 40 years and her husband, my grandfather, retired from the United States Air Force after 25 years. I was born into a family whose life goals were to always put the safety and health of people first. I remember when I was six years old, it was Halloween and I wanted to be a nurse. My mother bought a pair of scrubs that I wore trick-or-treating, and once I put those scrubs on, I just loved the way they made me feel. I knew then that I wanted to be a nurse. I wanted to put the health and safety of people first, as my family did, and I wanted to make them proud.
Fast-forward, to August 2015, I made the choice to start nursing school and ultimately become a registered nurse. It was scary and overwhelming, but I was also very excited to officially be on the path that I chose when I was 6 years old. The nursing school laid out the foundation I would need in order to be successful. I completed my associate's degree in nursing in August 2017. Two months later, I took the NCLEX and passed on the first try. I gained employment at an emergency department in December 2017. Being a brand new nurse at the time and starting in the ER was a bit overwhelming, to say the least, but here I am two years later, still in the ER, enjoying every minute and every new opportunity to learn.
After being in the emergency department and gaining experience over the course of the past two years, I decided I wanted more. I wanted to turn nursing into a profession. I started looking into “RN to BSN” programs and found South University. Many factors influenced my decision to take the leap. Hospitals are starting to require registered nurses to either have their BSN prior to starting the job, or they give you a timeframe to start and complete a program and earn your BSN degree. Studies have shown that nurses who have obtained their BSN degree improve patient outcomes in the clinical care setting versus nurses who have a lesser degree. For example, BSN nurses have been shown to lower mortality rates and have more efficiency in properly diagnosing patients. O, B. D., Knowlton, M., & Whichello, R. (2018)
Obtaining my BSN degree will change my current role in the emergency department setting. My current role as a Clinical Nurse II on the unit basically states that I have 2-3 years of experience and that I can be a preceptor to teach new graduate nurses on the floor. It also gives me the opportunity to be the lead nurse in any of the traumas, codes, or STEMIs (ST elevated myocardial infarction) that come through the doors. After completing the BSN program and transitioning into that role, you get to add those initials to the end of RN. It will be “RN, BSN”.
As soon as people see those extra letters on your badge, I feel that they approach it differently. Nurse managers and directors approach you with more respect and they can trust your decisions. BSN nurses at my hospital have more opportunities than those that are not. Once you obtain the degree, you can branch into being a Nurse Educator on the unit, assume the role of the Charge Nurse, or become a Nurse Leader. I would love the opportunity to be in any of those roles, as I believe it would increase my experience and improve patient satisfaction.
After reviewing the models of socialization by Cohen and Brenner, I have chosen to place myself in Brenner’s model. I consider myself a new nurse, with only been a licensed registered nurse for two years. I immediately started working in the emergency room post-licensure and have fallen in love with it. In Brenner’s model of socialization, I have placed myself in Stage III, otherwise known as “Competent Practitioners”. Stage III is especially important for new nurses like me, with 2-3 years of experience. Being in this stage requires competence, efficiency, and prioritization (Black, B. 2016). In my opinion, working in the emergency department requires many characteristics to be displayed by each nurse. A nurse must display flexibility, timeliness, prioritization, compassion, and mental stability to name a few.
When I first started in the emergency room, to say I was nervous would be an understatement. Multiple people mentioned, “you should start out on med -surge just to get your feet wet”, but I knew where I wanted to be. My preceptorship lasted 16 weeks: two 12-hour shifts and one 12-hour class day a week. The night before my first official day on my own, I kept running through different scenarios in my head. For instance, if a STEMI or Stoke Alert came in, what are all the items I need to set up, what medications should I think to have ready, what should I have on standby, etc. Just my luck, I had two STEMIs and one Stroke Alert on my first day, and I got through it. Fast forward two years, I am now the one that new nurses come to and ask questions. I am now fully competent and efficient among other characteristics, although the learning never stops. Within the next year or so, I hope to branch into Brenner’s fourth stage, “Proficient Practitioners”. (Black, B 2016.) Emergency nurses have a piece of in-depth knowledge and high skill set because they see all different types of people across the lifespan and they direct their care to each patient as needed per age/background/scenario. “Emergency nursing care is episodic, primary, typically short-term, and occurs in a variety of settings,” (Solheim, J., & Sigma Theta Tau International.).
Over the past four years of finishing nursing school and starting my career, I have completed many goals that I set out for myself. For instance, I wanted to get through nursing school with flying colors, sit for the NCLEX and pass on the first try, get hired, and obtain my dream job in the emergency department; all things that I have completed thus far in my nursing career. I set a timeframe for myself to start and complete my BSN. I wanted to start before the new calendar year of 2020, which I am now currently doing. Two professional short-term goals that I would like to complete are finishing my BSN with ease and taking the CEN (certified emergency nurse) exam. As stated before, finishing up my BSN will open new doors of leadership for me in the hospital setting. The CEN exam is for nurses working in the “emergency department setting who want to demonstrate their expertise, knowledge, and versatility in emergency nursing”. (Board of Certification for Emergency Nursing, 2015)
Completing the CEN, as well as BSN, will not only show my knowledge in professional nursing but will also show a higher level of knowledge and experience specifically related to emergency nursing. The Certified Emergency Nurse exam, has proven results that nurses who become certified demonstrate increased knowledge, better skills, and overall substantial performance in the critical care setting. (Board of Certification for Emergency Nursing, 2015)
After accomplishing the short-term goals I have set out for myself, I would like to set two professional long-term goals for myself to complete before I am thirty years old. I am now twenty-five years old. By the time I complete my short-term goals of completing my BSN and passing the CEN exam, I will be just turning twenty-six. I have always wanted to be a nurse practitioner, more specifically an Emergency Room Nurse Practitioner. Within the next four years after completing my BSN, I would 1) like to start and complete an NP program, and 2) take the boards and land a job in the emergency department as an NP. Switching from the role of a registered nurse with a BSN in the emergency room to a nurse practitioner in the emergency room opens a multitude of doors for oneself. Nurse practitioners in the ER can manage and treat acutely ill patients across the entire lifespan. Having nurse practitioners practice in the critical care setting improves access to care and lessens the workloads of physicians, thus physicians can spend more time in the critical trauma rooms if needed. According to the Association of American Medical College (AAMC), there will be a national shortage of roughly 41,000 – 105,000 physicians because of our nation’s increasing population and increase in the average age of the geriatric population. Nurse practitioners and physician assistants are already filling the gaps needed in the clinical care setting. (Association of American Medical Colleges, 2019)
There are challenges and barriers that will be set forth in front of me as I accomplish my short-term and long-term goals. Challenges that I will face in completing my BSN will be learning exactly how to apply everything I will have learned, concisely and efficiently, into the clinical care setting as well as in everyday life. I believe that balancing enough time for my BSN and studying for the CEN concurrently could also post a minor challenge, with all of my focus currently being put into achieving my BSN first. My husband and I have been married for two years and we have decided that we will want children in the near future. As with all things in life, sometimes things get in the way of certain goals when you add new factors that can change the game. As stated earlier, I would like to become a nurse practitioner and be hired in the emergency department before I am thirty years old. If my husband and I would like to have kids, I believe it could pose a challenge in the timeframe that I set for myself.
With different challenges and barriers being set before me, it is also beneficial to have a support system. If I struggle to learn how to apply knowledge from my BSN in the clinical care setting, my Nurse Manager and ER Director will be my mentors. They will ensure that I make the transition with ease and are available for any questions regarding my new role. My husband is my main supporter along with my family. When my husband and I choose to have children, he will make sure I have a set-aside time to study for school as well as have a mental break here and there. My family will help to ensure I have everything I need to complete the goals I have set for myself. With my mentors and support system, I believe I will have absolutely no problem finishing my BSN, passing the CEN, earning my MSN, becoming a nurse practitioner, and landing a job in the emergency department.
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