Professional Development Plan

Professional Development Plan: Critical Care Nursing

Amy Lichtfuss

Rush University College of Nursing

Professional Development Plan: Critical Care Nursing

Our nation has faced a variety of exceptional events these last few years that have shaped and are reshaping the traditional health care system we have known for over a century. Between the influx in disaster-related events, impactful government rulings, changing populations, and advances in medicine, the world of nursing is becoming more essential than ever expected. I am thrilled to be entering this field at such a vital time in our healthcare’s history. 

Environmental Scan

            It is 2014 in the United States; baby boomers are aging, obesity rates are rising, and chronic health conditions are multiplying (Huber, 2014). Centers for Medicare & Medicaid Services (CMS) are urging shortened hospital stays and refusing reimbursement for preventable conditions, the Affordable Care Act provided insurance for an additional 30 million Americans and together with Healthy People 2020 are demanding better access to health services (including emergency care), and our nursing workforce is aging and diminishing at the same time (Huber, 2014; Healthy People, 2013). This evident increase in patient acuity and reformed healthcare system, combined with the constant threat of natural disasters (Hurricane Katrina, tornados), terrorism (9/11, Boston bombing), and disease outbreaks (influenza), critical care nursing is a specialty that is realizing the importance of needing to be stronger, wiser, and more prepared. Fortunately, the job outlook is expected to grow 19% by 2022 (US Department of Labor, 2014), providing many opportunities to get involved. 

            Locally, Chicago is trying hard to keep up with the demands of the increasing complexity and quantity of patients. With six level-one trauma centers in Chicago, our EMS teams have refined transporting patients, we have emergency procedures for any natural or man-made disasters (Johnson, 2013), and our trauma teams are practicing with expert knowledge and skills. Yet our workforce is strained by high nurse to patient ratios and this will get worse as nurses take on more responsibility for outcomes and as patient care becomes more complex. With inevitable and unrelenting traumas, increase in chronic illness, and 2.8 million residents, Chicago needs highly competent critical care nurses to help our city become stronger, wiser, and more prepared.

To be an excellent critical care nurse one needs to employ a particular set of skills, such as flexibility, ability to prioritize, resourcefulness, reliability, teamwork, effective communicator, autonomy, and being able to think critically, act logically, and make decisions under pressure. Through previous work experiences I have obtained these skills, and also have social skills that allow me to engage with patients therapeutically yet effectively regulate emotionally charged atmospheres.

Self-Assessment

            Key values I identify with include intelligence, competence, teamwork, integrity, respect, and empathy. I believe these values are essential for any nursing position and they have been and always will be the foundation for all of my professional decisions. Some of my best strengths include being organized, efficient, and able to manage time well, multitask, anticipate needs, and think on my feet. I thrive in busy environments, love the challenge of maintaining control in chaotic situations, and understand the value of a close working relationship with peers and superiors. I have an internal drive for learning, knowing, doing, and serving and being my best self. These attributes and ambitions will not only help me succeed as a nurse but will help me flourish in the critical care arena. 

I am aware of some limitations I will need to address or modify to fit the needs of my career. The first is that I have not had any consistent experience working in a critical care setting. However, my inspiration stems from facing family traumas and a deep internal desire to save lives and practice exceptional nursing. Recent observations in Rush’s surgical intensive care unit and Emergency Department (ED) reinforced this passion. Also, while I am flexible and able to change gears quickly, I easily settle into routines. Knowing this about myself has forced me to practice mentally preparing for unpredictability. Coincidentally, normal routines are less common in critical care where uncertainty is the only guarantee. Ultimately, as a new nurse I am limited in regards to an overall proficiency and expertise that is gained only by experience. 

Areas of professional growth I will address include better delegating, refining my delivery of health education, applying advanced knowledge of pathophysiology to practice, and polishing my nursing skills. In critical care, nursing competency across the lifespan is essential and this will be a constant area of growth throughout my career. To be better prepared for my first critical care position, special skills to focus on during immersion include inserting IVs, interpreting lab results and EKGs, hemodynamic monitoring, and becoming proficient with advanced technology. I always welcome constructive criticism and fully intend on implementing feedback to better my nursing practice in terms of knowledge, best practice, and leadership.

Vision

Overall I envision myself being as versatile as possible within the critical care field. I want to feel comfortable working with all age groups and be transferable between ICU, ER, and trauma centers. I am aware it is difficult for new graduates to find a job in critical care without any previous experience. Accordingly, within one year after receiving my MSN I envision myself working for a general hospital in an adult acute care setting, gaining experience and building confidence in my new nursing role with support from a residency program and other resources from nursing organizations (webinars, CEUs, etc.). I will be an active member of the American Association of Critical Care Nurses (AACN) and participating in continuing education focused on critical care across the lifespan. I will also be working towards a certification in critical care (CCRN), the exam for which is provided by AACN and is available after 1,750 hours of critical care experience over two years (AACN, 2014).

By three years after graduation I will be settled in my personal life, living in the suburbs of Chicago, and secure in a critical care position at a major hospital’s ICU, ED, or trauma center in the surrounding area. I will be certified as a CCRN, with additional certifications in PALS and ACLS and using my CNL to impact the microsystem and improve patient outcomes (AACN, 2007). With a future eye on flight nursing I will be focused on refining quick assessments and nursing skills across the lifespan, while networking with mentors for guidance. A DNP program is also on my radar after I have established my nursing career.

Strategic Plan

My goal for my first position as a registered nurse is to secure a job in an adult medical/surgical or critical care unit in the Chicago area. During the last term of nursing school I will focus on improving the aforementioned areas of growth, push my comfort zone in terms of leadership, skills, teaching, and independence, and develop relationships with mentors and leaders in this specialty. I plan to have my resume, cover letter, and portfolio prepared and available to prospective employers by the last day of classes, August 15^th, 2014. I feel it is important to show ambition and initiative by getting resumes out as soon as possible. I plan to take the NCLEX by October 2014 and hope to secure a job by January 2015. 

Indicators of success include having first passed the NCLEX, followed by securing a job in an adult medical/surgical or critical care setting. Beyond that, I feel that success will be based on feeling comfortable in my job while receiving support from mentors, experienced nurses, and leaders who can guide me toward my long-term goals.    

References

American Association of Colleges of Nursing (AACN). (2007). White paper on the education and 

            role of the clinical nurse leader. Retrieved from

http://rulearning.rush.edu/bbcswebdav/pid-247129-  dt-content-rid-2349999_1/courses/14SPCON-NSG-512-1/CNL-Competencies-October-2013.pdf

American Association of Critical-Care Nurses (AACN). (2014). Initial ccrn certification.

Retrieved from http://www.aacn.org/wd/certifications/content/initialccrncertification.pcms?menu=certification

Healthy People. Department of Health and Human Services. (2013). Access to health services. 

             Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?

            topicid=1

Huber, D. (2014). Confronting the nursing shortage. In L. Workman (Ed.), Leadership and nursing 

            care management (5^th ed., pp.339-366). Maryland Heights, MO: Saunders Elsevier.

Johnson, C. (2013, February 28). Chicago trauma care: South side violence drives push for treatment 

            center's reopening. Huffington Post Chicago. Retrieved from        http://www.huffingtonpost.com/2013/02/28/chicago-trauma-care-south_n_2783811.html

U.S. Department of Labor, Bureau of Labor Statistics. (2014). Occupational outlook handbook, 2014-

           15 edition, registered nurses. Retrieved from http://www.bls.gov/ooh/healthcare/registered-

          nurses.html

Critique by Kelsey Mullen

The healthcare trends were identified clearly for both the nation and locally in Chicago in relation to the increasing need for critical care nurses. The current healthcare environment changes as well the impact that society as whole plays on this area of nursing supported the student’s desire to obtain a job in the critical care arena. The job outlook for the nursing environment could be expanded.  For example, identifying statistics pertaining to current job market or critical care job opportunities.

            The self-assessment was personal and provided great detail about the student’s interest and capabilities that would allow her to not only work in but also be successful in critical care nursing. Multiple strengths were discussed in confidence and limitations were identified as well ways to improve clinical competency. The main weakness identified was lack of experience, which is to be expected with any new graduate but being able to capitalize on opportunity to gain more experience is a great idea. Being able to self-reflect and mentally prepare for change and flexibility will also be valuable in the critical care setting. I recommend identifying more values specifically geared toward the patient population you hope to work with, such as prevention of acute exacerbation of prevalent chronic illnesses.

            The one year and three year career goals are realistic and include a lot of specific action steps that will help continue her professional development. I recommend to take stock in the unit and the so called “behind the scenes” of bedside care, perhaps joining a unit committee. This will demonstrate investment in the institution and promote outcome driven care. 

The plan is specific, complete and thoughtful. Identification of concrete steps and dates is important, but some flexibility should be considered. 

APA format included, easy to follow thoughts, and great content.