Throughout my nursing education, I worked to complete seven ADN outcomes during clinical.

The
first ADN outcome was to implement ones role as a nurse that reflect integrity, responsibility, ethical
practices and an evolving professional identity as a nurse committed to evidence-based practice, caring,
advocacy and quality care. I have worked diligently to meet this competency by treating all individuals with
dignity and respect as well as protecting patient rights. During clinical rotation, I always made sure to log off
the computer when I was finished charting. This prevented other staff from using my login to chart as well
as protected patient information from getting into the wrong hands. Another way I met this competency was
by maintaining privacy while completing my assessments with patients. This was done by closing the door
when performing an assessment and asking family/friends to step out unless the patient requested they
stay.
Demonstrating appropriate written, verbal, and nonverbal communication in a variety of clinical
contexts is the second competency. I feel that I have met this competency by providing accurate, concise,
and relevant information to patients, families, and team members. I have completed this competency by
explaining to my patients the use of their medications and how they pertained to their treatment process.
For example, I had a patient which had fluid volume overload r/t heart failure and was prescribed IVP Loop
diuretic for treatment. Knowing this I explained to the patient how the loop diuretic would help to get rid of
the excess fluid to decrease the dyspnea they were experiencing. This gave me a chance to explain how
the diuretic would create the urgency to urinate, so this should be expected. Another portion of this
competency I met was, adapting communication strategies based on patients' age, developmental level,
disability, and/or culture. This was met when I had to adapt to an elderly patient who was hard of hearing by
speaking louder. It was a challenge to determine just how loud to talk so the patient could hear me without

speaking too loud that I might be giving out personal information to people overhearing in the hallway.
Overall, I made the adjustment and feel more comfortable with this skill.
Integrate social, mathematical, and physical sciences, pharmacology, and pathophysiology in
clinical decision making is the third competency. I believe this competency was met by Incorporating
pathophysiology of disease(s) to patients assessment findings, medications, laboratory & diagnostic test
results, medical, & nursing interventions. An example is when I was working with a patient who arrived in
the ER with a blood glucose level of 892 and was diagnosed with DKA. This patient explained how he had
polyuria and polydipsia before he passed out and woke up in the hospital. Prior to this, he had no idea that
he had diabetes much less what it was exactly. I took this as an opportunity to teach my patient about
diabetes as well as the signs and symptoms of hypoglycemia and hyperglycemia. Also, this patient was a
newly diagnosed diabetic, so I took this time to explain why he was receiving insulin and that it was very
important he keep taking it every day as prescribed. Another way I met this competency was by
Incorporating theoretical & evidence based knowledge to analyze relevant data to support clinical decisionmaking. An example of this was when I had a patient who was on bleeding precautions for an extremely
low blood platelet level. This patient had a complex situation of acute renal failure and was on dialysis. After
collaborating with my instructor and looking up hospital policies, I asked my nurse if the patient should be
taken off bleeding precautions. I explained how the hospital policy states that if platelet levels are above
50,000 then bleeding precaution signs can come down. However, they ultimately decided to leave them up
as a precaution.
Provide patient centered care by utilizing the nursing process across diverse populations and
health care settings is the fourth competency. This competency was met by adapting priorities based on
diverse patient care needs. An example of this was when I had two patients and one was diabetic. Knowing
this, I coordinated and delegated care with the CNA. This patient was to receive fast acting insulin before

dinner, therefore I delegated the task of obtaining the blood sugar reading to the CNA so I could prepare
the patients insulin. Once the dinner tray arrived, I was able to immediately give the patient their insulin
thanks to exceptional teamwork and delegation. Giving insulin was a priority before other care in order to
best control the patients blood glucose levels. Another way that I feel I met this competency was by
differentiating between relevant & irrelevant data. It is a transition between long term care nursing and
hospital nursing. I was constantly looking for updated doctors orders and notes to see what I needed to
know and what was a priority at that moment. Another way I received practice with this was when I had to
determine which information was relevant to pass on in report to the nursing staff. This was difficult at first
because I wanted to give more than enough information, but I soon realized I just needed to pass on
pertinent information because the rest they can look back in the chart for.
Minimize risk of harm to patients, members of the health care team and self through safe individual
performance and participation in system effectiveness is the fifth competency. I feel I met this competency
by applying industry standards in protecting patient, self & others from injury, infection, & harm. An example
of this is every day I would check my five rights three times with each medication before giving it. Also, with
IVP medications, I always looked up whether or not it was compatible, needed to be diluted and how much
time to give it over. When giving the medication, I always checked the patients name band and had them
tell me their name and date of birth to make sure I had the right person. Also, when giving an IV medication,
I always made sure to clean the port before each flush and medication to provide sterility.
Lead the multidisciplinary health care team to provide effective patient care through the lifespan is
the sixth competency. I believe I met this competency by delegating tasks appropriately according to the
state nurse practice act. An example is that over the weeks in clinical I worked to become more comfortable
with the role of being the nurse and delegating to the CNA. It is a difficult transition to delegate to someone
when you are used to getting delegated to, however it does come more natural with practice. During

clinical, I had to delegate tasks such as taking blood sugars and getting vital signs. For me, once I
established trust and respect with the CNAs, delegating became easier and more comfortable.
Use information and technology to communicate, manage data, mitigate error, and support
decision-making is the seventh competency. I feel that I met this competency by documenting complete,
accurate, pertinent information in a timely manner using electronic or agency standard documentation
systems. An example of how this was met is by completing one patients assessment and then immediately
charting my findings before starting my second patients assessment. By doing this, I was able to
remember exactly the correct information to chart while it was fresh in my mind as well as prevent possible
error from mixing up patient information. Another thing is, I would chart my pain assessments as well as
medications given and then go back and rate their pain within the appropriate time frame. I would then
immediately chart the patients response to maintain consistency and follow up of their care. Overall, I have
worked very meticulously to hone my clinical skills by working to meet these competencies. These
experiences have helped me grow as a nurse and future health care professional to meet top quality
patient standards and outcomes.