Running head: SENIOR CAPSTONE REFLECTION 1

Senior Capstone Reflection

Nathalee Walker

Southern Illinois University Edwardsville

Senior Capstone Reflection

Introduction to My Self-Development

As I stepped on the plane, the sand crunched beneath my toes. I was leaving Jamaica,

which had been my home for 23 years. As I sat in my seat, the flight attendant announced to

travelers that it was time to fasten our seat belts. I took a deep breath as I thought about how

many miles I would be running in boot camp tomorrow. I had my whole life in a mellow,

leisurely country and now I was heading to the United States.

In Jamaica, my family always pushed me to attend school and to achieve excellent

grades. I struggled to find inspiration in my last year of school. I attended a lucrative,

Pharmacology Program at The University of the West Indies in Kingston, Jamaica. Although I

enjoyed learning, I enjoyed the laid-back environment I had lived in my entire life. After my last

semester, I decided that I was going to join the United States Navy to help me find my passion

and develop into a professional.

Areas of Learning and Program Outcomes

Diversity

The national motto of Jamaica is “ Out of Many One People”. As a native-borne

Jamaican, I never thought that people were different from one another. When I came to the

United States, I realized that diversity was an issue in healthcare. Diversity is not a word you

would hear in Jamaica. With the diverse population in America, it was easy for me to treat

people equally regardless of their cultural or ethnic differences. I spent my time living and

learning around a vast community. No matter if a person is older, younger, black, or white it

would never affect the type of care I would provide.

During my undergraduate nursing experiences, we learned about diversity, which was a

culture shock for me. I did not realize that diversity, as a part of nursing curriculum, was

something that needed to be learned. I began to observe situations within my clinical and service

learning experiences that demonstrated why diversity must be addressed. I perceived that the

nurses in the clinical setting did not spend the same amount of time explaining procedures to

older patients as they did for younger patients. They would simply enter the room perform the

tasks and leave.

From my observations in the nursing home, Alzheimer’s patients were treated with lest

respect than alert and oriented patients. These experiences have ingrained in me a deep

appreciation for the importance of providing non-judgmental care. Every patient has the right to

expect equal treatment and to receive the same quality of care as the patient in the next bed. As a

nurse, I will provide unconditional, non-judgmental care to every patient, despite the patient’s

socioeconomic background, ethnicity, culture, beliefs, race, skin color, educational level, or

religious beliefs.

Communication

During my general education, I took a public speaking class, which was my first

structured communication class as a student. Nursing coursework and clinical experience has

taught me a lot about logical written communication. Group work assignments have taught me

how to communicate my ideas to others and listen to their ideas. I have learned that when

working with other people it is important to remember that each person has a point of view and

wants to be heard.

During clinical rotations, I communicated with other members of the healthcare team

about significant events or any patient concerns. At the end of the clinical day, I recorded patient
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information in the chart, assessments, and provided handoff report to the oncoming nurse. These

communication techniques ensured continuity of care and reduced any errors or omissions. The

patient has the right to understand the care I provide them, what will be done, what results to

expect, and what alternatives are available to achieve a desired outcome. The ability to

communicate is essential to imparting accurate and effective nursing care. I have learned to

exemplify this by speaking with patients at their knowledge level, avoiding medical jargon, and

being conscientious of my nonverbal behavior.

During my nursing home service learning experience, I helped an older woman place her

chips on the bingo board until she became upset with me. I proceeded to listen to her an

understood that she wanted control of her situation. Listening is a very important in

communicating in nursing. As I talked to the patients at the nursing home, I identified that some

patients felt uncomfortable with direct questions so it was important to use open-ended questions

instead. From this experience, I learned to facilitate discussion about gaps in communication

while maintaining a standard of care.

Ethics

Growing up in Jamaica under my family's roof fostered the development of my moral

compass because of the strict environment I lived in. That moral compass further developed as I

entered the Navy, in which shortcuts were unacceptable and punishable. The consequences and

effects that poor decisions have on others have motivated me to contemplate my decisions before

acting on them. While I was in California at Trident University International, I took an ethics

course that covered ethical principles such as veracity, autonomy, beneficence, and fidelity.

These reinforced the value system I set for myself, including my past cultural experiences.
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During my clinical experience, I observed a nurse who violated the ethical principle of

patient autonomy. The patient coded the previous day, was resuscitated, and then signed a do not

resuscitate (DNR) advance directive. The following day, in which I was caring for this patient,

the nurse pressured the patient to reconsider her DNR decision. Every time that we went into the

patient's room, the nurse brought up the fact that the patient could change her DNR status. The

doctor was upset because the nurse was continually imposing her own opinion on the patient.

I learned that just because a patient chooses something that is not within my moral

compass, I have to care for that patient and be their advocate regardless of my own personal

feelings. The patient has the right to make his or her own decisions. Patient-centered care has

been the foundation of SIUE School of Nursing curriculum. As a healthcare provider, I will base

my actions on legal and moral standards and what is best for the patients. These ethical

principles highly influence my decision making in order to overcome ethical dilemmas and to

maintain the patient's autonomy and the right to do and / or duty of care.

Role Development

During my leadership and community health classes, I have learned a lot about situational

decision-making. The coursework included group assignments, which initially were a challenge

for me. As a member from the Navy, I am accustomed to being a leader and I found it

challenging to take the role of team member. In the leadership class, we were able to take a

personality test that identified my strengths as attentive to details, organized, practical, and

assertive. A weakness of my personality is that I am usually unwilling to change the way I do

things without evidence to support the change.

Through working in groups in both of these courses, I have learned to work with others to

reach a common goal. In the Navy, it was very much a hierarchy; people near the top gave orders
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to those in lower rank, which they performed without question. In the group setting I learned to

compromise and communicate with others, despite any differences I had with them. I was able to

lead the group to complete our community project because I placed my differences aside and I

learned how to be both a team member and a leader. In my professional practice clinical, I was

able to care for multiple patients at a time and acted as the Team Leader for two to three other

students, each assigned multiple patients.

After caring for multiple patients, I learned to design my day in a way that ensured

patient-centered care and safety. It has taught me how to co-ordinate care, use knowledge, and

hold myself accountable for making safe patient-care decisions. I also acted as a resource for

other students to help them problem solve issues, such as when a classmate needed help

interpreting a lab value. As I cared for my own patients, I assisted the nursing staff in any way

possible, I realized my role as a provider for all patients, and to help members of the team in

achieve their goals.

Clinical Reasoning and Prioritizing

Team cohesion, accountability, and the ability to follow orders were instinctive to being a

member of the Navy. Before I was a nursing student, I had learned how to complete tasks as an

engineer. For example, one of my duties was to assess the spaces of the ship. In doing this, I had

to focus on tasks such as inspecting the main engine rooms of the ship before checking storage

rooms. If something were to go wrong, it was more pertinent to know the status of the main

engine room. As I progressed into nursing and clinical experiences, this ability to make priorities

has allowed me to complete the program outcomes.

As a team leader in my professional practice clinical, I was able to discuss with team

members the factors that made one patient a priority over another. My nursing coursework has
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enhanced my ability to make decisions by using the nursing process, a logical way to approach

patient problems, assess the patient's status, and respond to varying situations.

Conclusion

The day I left Jamaica, looking out the window of the plane, I could not see the giant

strides ahead of me. My time in the military helped me mature while preparing me for the

challenge of nursing school. As I am four weeks away from completing nursing school, I can

honestly say that this program has played a large role in my professional development. I have

learned invaluable lessons about teamwork, perseverance, and communication that have allowed

me to become a graduate professional nurse.

As a professional registered nurse, I intend to advocate for my patient's and attend to their

multidimensional needs. I intend to becoming a leader within my field, a team member, and to

help others reach their goals of patient-centered care and safety. This has been the most eye-

opening experience in my lifetime and I am glad that I have found my passion. With excitement

and anticipation, I look forward to the next chapter of my life's journey as a Registered Nurse.