PGC Reflection Paper

Katherine A. McCarthy RN

Delaware Technical & Community College

NUR 460-201 Nursing Capstone (Spring 2023 S1)

Dr. Wagamon

March 8. 2023

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 Achieving my PGCs

I have always been a goal-oriented type of person, when I see something, I want I make a

plan to get it, sometimes it works out on the first try, and other times I have to change my

strategies. Over the years my goals have changed, and I am still not sure of exactly what I want

to be when I grow up. My most recent set of goals included the completion of the BSN nursing

program, so this being my final paper, I can check that box. The PGCs or Program Graduate

Competencies must be met before completion of the program, there are nine of them in this BSN

program. For me, meeting these goals flowed very well with the program, and in the beginning, I

did not even realize I was building the framework needed for graduation. The first goal, to

integrate general education knowledge, skills, and aptitude to advance nursing education and

growth in professional practice, actually started back in the very beginning with English comp,

Technical writing, and in the AND program. Learning how to write a paper in APA format and

using correct grammar was just as important as learning to use critical nursing skills for

assessment in patient care and management. The second goal, to demonstrate leadership skills to

promote safety and the delivery of high-quality healthcare, also began back in the ADN program

but was highly nurtured in the BSN program. From the classes dedicated just to leadership

teaching to doing my practicum with a leader, such as an emergency department supervisor and

an NP at a busy primary care office, I feel I have met this goal. As for the third goal, analysis,

and information literacy to support evidence-based professional nursing practice, this was met

slowly over multiple classes. In Nursing informatics, I learned to use the technology available to

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get the facts needed to complete nursing research using evidence-based articles and research

papers. The fourth PGC, integrating information management to improve patient outcomes, goes

right along with the third one, in the nursing informatics class I learned to use technology such as

EMR systems to ensure patients have the preventive testing or procedures they needed. At my

practicum with Ryan Brown NP, he showed me how their system was set up to notify them when

each patient needed care, such as mammograms, PSA, labs, colonoscopy, or vaccines, when

patients have the recommended preventive testing done their outcomes improve. Advocating for

my patients has always been a passion of mine, so the fifth PGC was an easy competency to

grasp, advocate for patients and the nursing profession concerning healthcare policy at the local,

state, national, and global levels just took it to a whole new realm. I was looking at it on a lower

scale, but when you see what can and is being done you realize the full scale of what your true

abilities are as an advocate, also I never thought about it as advocating “for the nursing

profession”. I now understand that as a nurse, I can be a part of a whole that can make changes

happen, in Nursing Policy, I learned how policies are made and changed and how to get

involved. I struggled a little with number six because I was not very good at delegating, things

were done right when I did them myself, what I learned is a good leader with teach those they

lead to do it right, the PGC, direct patient-centered care through advocacy, interprofessional

communication, collaboration, and delegation also taught me how to be part of a team and work

with others toward a commons goal. Many of my classes had group projects, not my favorite.

What I learned is, they are not my favorite because I did not know how to work together as a

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team, but once I became confident in my abilities it was much easier. Number seven integrates

health promotion and disease prevention practices to positively impact the delivery of healthcare

to diverse populations, during my practicum with Ryan Brown and with Stacey Propper at Tidal

Health I had the opportunity to work with many different populations, from different cultures to

different levels of social disparities. Unfortunately, in the emergency room setting, some staff

showed little to no tolerance for socially challenged patients. At one point a patient the drank too

much mouthwash fell off a ramp, he was unable to walk and required a wheelchair for all

ambulation, he fell at a hotel he was staying at and was sent to the ED, they treated his injuries

and called for transportation to send him back to the hotel, knowing his wheelchair had been left

at the hotel and they did not know which hotel he came from, they told the driver to take him to

the area where the hotels were and he would figure it out. I found this very sad, they did call in a

social worker and he was able to get the man into rehab, but it was Sunday night, and they could

not take him till morning, but they refused to hold him in ED until then. I know it is a lot to deal

with and as a coping mechanism we use laughter, but some staff just seemed uncaring are made

jokes about him, I spoke with Stacey about this and she stated the man is a frequent flyer and

spends most weekends at their facility. I just wonder, if someone had taken the time to truly help

him would he still be a frequent flyer, maybe so but without hope what is the “Why” of what we

do? Then we come to number eight, practice professional nursing within an ethical framework,

this ties into the hospital experience I think, is it ethical to just send a patient, even a frequent

flyer, to an unknown location without him having the ability to even walk, what was the driver to

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do just leave him on the sidewalk. During my Ethical Issues class, I learned many things about

ethics, such as, not everyone feels the same way about everything, and patients have the right to

refuse care or request continued care in some cases even if it is not what I feel is the right thing

to do. Finally, PGC number nine demonstrates lifelong learning that empowers personal and

professional growth. When I completed the ADN program, I never intended to return to school,

never say never I guess, because here I am. However, now that I am at the end of the BSN

program, I am already looking into my MSN, I feel that if I do not do it now, I may never do it. I

have also learned in every class throughout this program that learning IS a lifelong process and

we should never stop learning. I plan to apply for the MSN program in the fall and I am looking

forward to the challenge, I am so grateful I talked myself into going back for this degree. It was

worth it.

My Practicum Experiences

As for my practicum experience, I have discussed most of it above, but I must say that

the experience was amazing, at first I honestly thought, wow how am I going to make this

happen, it just did. Everything just flowed into place and when it did not, I received all the help I

could ever need from my instructors or preceptors. Yes, it was difficult, getting time off work,

and getting up at 2 am to be in Salisbury at 250am for a 3A-3P shift both Saturday and Sunday,

was not my favorite part. But once I was there, it just flowed and of course as in any emergency

department, it was crazy busy the whole time, so time just flew by. The time I spent in the

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primary care office with Ryan Brown may not have been as exciting, but it was very interesting,

many patients he saw were referred by the ED both at Nanticoke and PRMC, they had no PCP,

and some had not seen a primary doctor in their life. So, to be able to help these people get set up

with the care they needed and begin working on some of their preventive care was heartwarming.

I enjoyed both experiences and I am glad they were so different; it was like seeing both sides of a

coin. One of my weaknesses identified in my SWOT analysis was a lack of empathy, seeing both

sides of the coin helped, also looking at the situation as an outsider gave me a completely

different view. I also found in that analysis that I struggled with organizational skills and time

management, both of which were addressed in my classes and through the practicum.

Summary

I do not think my nursing philosophy has changed much I still feel that education is the

key factor and to grow or improve we must understand. This BSN program has just solidified

those philosophies for me, and I hope that will continue to be the case.

The instructors in this program have supplied me with all the tools I need, now it is up to

me to put them to use and continue to sharpen them by continuing my education and always

being willing to learn.