Self-Assessment of Clinical Skills, Exams of Nursing

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RUNNING HEAD: SELF ASSESSMENT OF CLINICAL SKILLS

Assignment: Self-Assessment of Clinical Skills Walden University NURS 6565 N-1 Synthesis Adv NP Primary Care November 30, 2017

Every individual have some types of qualities that are called strengths and weaknesses. An individual strengths and weaknesses have the ability to influence that person decisions. It is very important as a nurse practitioner student that I find my own strengths and weaknesses. Good strengths can make an individual more focused person as compare to weaknesses makes a better individual in a long run. The purpose of this paper is to address three strengths and weaknesses along with three clinical skills that this nursing student would like to master before exiting nursing program. Strengths Communication Skills: Communicating effectively with my coworkers, patients or their family is one of my biggest strength. Even my previous preceptors and his office staff members have told me that I have a very effective communication and interpersonal skills. According to Seidel, Ball, Dains, Flynn, Solomon & Stewart (2015), establishment of positive patient relationship starts from communication that is build on courtesy, comfort, connection, and confirmation. I tried my level best to listen to my patients actively rather than putting my own ideas. This way I can understand what my patient is trying to say so that we can respond appropriately. During patient and provider meeting, I begin my conversation with open-ended questions and end with “ is there any other questions or concerns that I can answer before I leave the room.” I give feedback appropriately, which is a gesture of respect that I am listening to their conversation. Documentation : Keeping contemporaneously charting in nursing world is very important. Documenting contemporaneously is one of my good strength that I am very proud of it. In my early nursing career, I invested a lot time to document contemporaneously that has become my habit now. Often we think, we have an excellent memory, but we tend to forget everything that happened throughout the busy day. Professionalism: Professionalism is characterized by speaking in collegial or professional manner; accept constructive feedback in positive way, respect the value of time, dressed and

talked appropriately. During my clinical rotations with my preceptor, I always tell my preceptor to correct me whenever I am making any mistakes. One of my preceptor actually left a feedback for me that I have a great desire to learn with inquisitive spirit, always respectful, open for suggestion, and constantly wanted to expand her personal sphere. Weaknesses Differential Diagnosis: Getting a through subjective and objective data, focused exam, and focused comprehensive patient history leads to accurate diagnosis. However, I tend to miss differential diagnosis here and there. One time my preceptor suggested that I should think about the potential life threatening diagnosis that can put the patient life in danger. Another way to address this huddle is by following the pattern recognition of signs and symptoms. Medication Prescribing: Medication prescribing is one of my biggest fear and weakness. My biggest fear is prescribing medication in pediatrician population. Neither I wanted to overdose nor I wanted under treat them. For me to become good nurse practitioner, my strategy is to collaborate with my supervising physician whenever I am double minded with prescribing medication, use of evidence based research, keeping pocket medicine handy, up to date, drugs.com, and downloading some useful apps such as epocrates. Scope of Services: As a family nurse practitioner student, we are encourage to decline the services that are outside of our legal scope of practice. However, in real world the situation is little different. I am one of those people who do not have the courage to say no to the supervising physician or to the management team. As a nurse practitioner student, many times I have witnessed nurse practitioner going out of their legal scope of practice because of the administration pressure. How do we deal with that type of situation? In future, as a nurse practitioner, if I feel like I am trapped in certain situation that I feel like it is out of my scope of practice. I would gather a courage to say no or will tell the administration to provide me enough orientation to do certain tasks, will go to alternative physician for consultation, and will make

sure that my competencies and experiences are enough to handle certain services or cases (Nurses Services Organization, 2012). Clinical Skills Suturing: I have been explored to suturing during my clinical rotations; however, I still feel that I need to work on know tying techniques. I have mentioned to my preceptor that I would like to get some hands on, if we get a patient who would require suturing. To gain more confidence and get to the near perfect, I have been using the tissue model to master the suturing skill. Cervical Dilation: During my clinical rotations, I have done many vaginal exams on well visits. My biggest struggle is when I have to check cervical dilation on pregnant women. My current preceptor is very knowledgeable and has given me the permission to do cervical dilation in her presence. Every time a pregnant woman comes to the clinic, my provider and I would get the permission from the patient. Also, I am planning to follow the guidelines recommended by women gynecological health that showed in detail how to find the cervical dilation (Schulling & Likis, 2017). As per my preceptor, practice makes perfect and I am determined that before I finish my clinical rotation, I will master this skill too. How to differentiate between skin conditions: To correctly categorize the skin can be a very stressful and confusing for a newly graduated nurse practitioner. Skin condition may be difficult to differentiate by appearance alone, so it is very important to consider the entire clinical presentation such as appearance of the rash, location, and other associated symptoms to help make the appropriate diagnosis (Allmon, Deane, and Martin, 2015).

Reference Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Mosby. Nurses Services Organization. (2012). Risk Control Self Assessment Checklist for Nurse Practitioners. Retrieved from http://www.hpso.com/Documents/Risk %20Education/individuals/NP_RM_Checklist_2012.pdf Buppert, C. (2018). Nurse practitioner’s business practice and legal guide. (6th^ ed.). Sudbury, MA: Bartlett & Jones Learning. Schulling, K. D., & Likis, F. E. (2017). Women’s gynecologic health (3rd^ ed.). Burlington, MA: Jones and Bartlett Publishers. Allmon, A. Deane, K. & Martin, K. L. (2015). Common Skin Rashes in Children. Retrieved from http://www.aafp.org/afp/2015/0801/p211.pdf