The profession of nursing is an empowering and everchaning field. As the population and technology continues to change there will need to pioneers that also adapt. As a current medical surgical nurse it is evident that more nurse will need to advance their careers and broaden their scope of practice. My future goal will to become a Nurse practicioner and to be able to be a provider with script authority. This path may be difficult at times, but the ability to play a tranformative role in someones life will be a rewarding feature. As  nurse practisioner my goal will be to work with the veteran population. As a former veteran it will be important to give back and help take care of my fellow service members. Mental health is an area that I would like to explore to be able to care for those who may be suffering from post traumatic stress disorder.

My professional mission statement will work as a guide as continued education will be important to become an advanced practice registered nurse. Ensuring veterans are well taken care off will be evident as my mission statement will empower change through increased care of veterans and an advanced scope of practice. This mission statement will also ensure that the profession of nursing is held to the highest regard.

The portfoilio contains artifacts that were attained during the course of study. Evidence-based practice has a total of three artifacts that are discussed more-indept in the area of study. Applied leadership section conatins an artifact of the required leadership exerpeince. Community and polulation nursing contains the Task from course C228. The Quality and Saftey Section contains the three required papers for the course. There are also two other artifacts and they are the Institute of Healthcare Improvment (IHI) certificate that was achieved during successful completion of IHI open school. The last artifact is the American Museum of Natural History (AMNH).

       The Artifacts in the portfolio are described in-depth depending on the content area. The artifacts reflect a higher level of nursing knowledge based on course competencies that were reached after successful completion of the performance task. The artifacts are also reflected in the definition of each of the four areas of study included in this portfolio. These artifacts highlight my professional growth as a nurse and also a leaders in the healthcare  environment. The amount of time and detail of each artifact shows a higher level of nursing and application of nursing theory.

     These artifacts are a testament of the desire to advance in the profession of nursing and become a change agent in health care. The certificate earned for the American Museum of Natural History (AMNH) displays an advanced understanding of genetics. This is a strength because it will be able to link risk facotrs when caring for someone who may have a genetic predisposition to the development  of a chronic disease. The Institute of Healthcare Improvement (IHI) certificate allows for a complex understanding of healthcare enviornment. Engagement of quality improvement will have a two-fold impact as it will ensure patients are receiving the best possible care, and help to reduce costs. The artifacts that are attached for the Evidence-based practice portion of the portfolio highlight my personal understanding of research and the importance of evidence before making a change in practice. The ability to differentiate between primary and secondary research along with appraise evidence are a strength that is highlighted in the artifact. The artifact that was submitted in the Applied leadership section highlights the the ability to manage a interdisciplinary team while trying to improve the early detection of delirium and develop a delirium protocol. The artifact that was submitted for community health highlights new strengths in the ability to analyze and detect the primary health concern for Carver County. The quality and safety section has a total of three artifacts and they highlight new found areas of strength in regards to healthcare costs, nursing sensitive indicators and failure modes and effects analysis. The artifacts show continued improvement and will continue to guide my growth as a professional nurse as I continue on with additional schooling to attain my eventual goal, and that is to become a nurse practitioner

          During the program time management was a significant barrier because of fulltime work, family and other events that occur. At times stagnation occurred with the courses and my first term did not go as planned. The plan was to complete more than 12 credits for the first term to lessen the load for the following terms of study. Organization was also a challenge and at times was a determinant to success for the program. Having to toggle back and forth between assessment and requirements for the task.

Statistics and Biochemistry were two course that took longer to complete then I expected. At times weeks went by with little to no progressions. At times the weekly phone calls with student mentor became difficult with my ever-changing work schedule where I would transition from day to night schedule.

To utilize time more effectively significant sacrifices were made and more time was allocated to weekly assignments readings and the completion of performance and objective assessments. The Cohort study sessions and the explanation of tasks were very helpful and explained in detail exactly what needed to be done. I commend the course mentors as this helped to expedite the process while still ensuring the course competencies were met. For the completion of both biochemistry and statistics, the recorded cohort videos were extremely helpful. Biochemistry was a lot of work, but it was well worth it in the end to see the blue light after the course was completed. Statistics was also another course that took a little more time, but it was the ability to stay engaged that helped with the completion of the course. The utilization of other resources such as YouTube was very helpful. Ensuring the weekly phone call with the course mentor was also another important feature that led to continual success. The weekly phone calls allowed for the continued goal setting and was helpful to stay on track with the programs.

Program outcome 1

Communication has been an integral part of the program at Western governors university. WGU The program has allowed for an enhanced level of communication and this can be attributed to the numerous means of communication with student and course mentors via telephone and through professionaly constructed emails. The performance assessmment required for the courses at WGU have had a positive impact and improved my ability to compose an essay. Professional communication is an essential trait that one must have due to the constant change in the medical field.

Program outcome 2

During the program the ability to utilize evidence based practice and improved clinical reasonin was enhanced through utilization of current literature and evidence.  Specific interventions are implemented when caring for a patient that may be at risk for a pressure ulcer. Clinical reasoning and judegment was also identified when identifing patients that may be at risk for falls. The program has imporved my bedside care and quailty of assessment to identify patients who may be at risk for potential injury.

Program outcome 3

During the program delegation and nurses rights and responsibilites was covered substansialy in the Professional roles and Values course. Understanding when a task should and should not be delegated is important for nurses. Nurse may transfer responibility for the completion of a task, but are ulitmatly accounatble to ensure the task is completed. Each state establishes a nurse practice Act which identifies the scope of practice fot the registered nurse. As a nurse it is important to ensure the legal rights are patients are not infringed upon. The identification of torts and  nursing ethics has improved my practice of nursing.

Program outcome 4

During the program there was an emphais on the ability to analyze data and theortetical, empirical knoweldge while also adressing the holistic view of the patient. Nursing is a very borad field as one must act as an advocate, manager, educator, and also care giver. A patient is more than their documented diagnosis or subjective concerns. when caring for a patient one must be able to see a patient's entire picture when developing ones plan of care. The utilization of evidence and resources may be neccessary when caring for a patient that may require additional help setting up medications or remebering to check their blood sugars. The most imporant feature or quality that was developed during the course of study was the ability to identify the numerous factors that are involved in a patient's life. Understanding a patient's social, spiritual, financial situation will help identify road blocks to wellness. Understanding a patients risk for comordities based on reserach and statistics will allow for imporved patient planning and teaching. A patient whose parents were both diabetic is at significant risk for developing dabetes. As a nurse education will play an important role in the further prevention of diabetes. Risk facors such as kidney failure may be attributed to high blood glucose levels. Identifing the patients resources. The utilization of clinical reasoning, the utilization on nursing theories a therotical and empirical knoweldge will have a postivie impact on patient outcomes. M y statitics course, evidence based practice course and professional roles and values course helped with the attainment of this outcome.

Program outcome 5

Cultural awarness plays an important role in the perceived believes and values regarding individual health care and practices. During Course C228 an interview took place with an individual of the chinese culture. There is a significant difference in regards to acceptance of western medication and increased amount of pharamcologial interventions compared to eastern medicine. Culutral awarness begins during self exploration and during assessment of patient. Identifing barries due to cultural difference will be important as a nurse as the demographics in the United States continue to change.

Program outcome 6
 The application of leadership and educational skill was met druring the creation of the delirium protocol. I was able to brief the task force on the important elements that should be addressed for the pilot study and the educational inservice. An educational posterboard was created that identified the specific risk factors, interventions an complications of delirium. As a new nurse the program helped further my leadership skills and ability to successfully manage a project. Additional work will be fine tuned as delirium is an important health concern in healthcare.

Program outcome 7

During the program of study and the leadership experience task, I was able to work alongside an interdisiplinary team. The goal of the team was the development and implementation of a delirium protocol at the VA Medical Center in Minneapolis, Minnesota. The goal of the protocol and the task force is the reduction of falls andm the reduction of hospital aquired delirium. Working with a phyisician, occupational therapist and also pharamicst helped to create and develop new rapports and working  relationships. These new rapports will have a postivie impact on patient outcomes.

Program outcome 8

Genetics plays an important role in determining risk factors and development of chronic ailments and diseases. Certain populations may be gentically predisposed to certain ailments, and it will be important to understand and indentify these health disparaties. Also important to note that nurses must be aware of genetic predisposition when caring for patient's. A holisitc view of patient's paternal and maternal health issues will be important for the identification of risk factors. This outcome was meet during the Community and Population health course and also through the attainment of the american Nuris

Program outcome 9

The ability to utilize technology in the medical field when caring for patients will continue to be of great importance. Bar code medication administration is an important feature that significantly reduces medication errors. The VA Medical Center utilizes a system called BCMA, Bar code Medication Administration. The utilization of electronic patient records and computerized bhysician order entry system will alleviate duplicate and ambigious orders. The Information management and application of technology course highlighted the technological advances for nursing and healthcare.

There has been substantial growth since the beginning of the program at Western Governors University (WGU). his program has been both empowering and transforming. An emphasis of quality care, evidence based practice are two areas that have been expanded through the study of courses and also the required performance assessment. The program also had a positive impact on professional communication skills. Time management and prioritization of tasks where also areas that were enhanced during the program at WGU.