6540

Procedure

Confident (Can complete independently)

Mostly confident (Can complete with supervision)

Beginning (Have performed with supervision or need supervision to feel confident)

New (Have never performed or does not apply)

Alternative drug administration (inhalation, transdermal)

X

Presenting history of present illness

X

Airway management (oral and nasal airway placement, intubation, extubation)

X

Ventilator settings (manages AC, SIMV, CPAP; analyzes ABGs to guide settings/Fi02, PEEP)

X

Non-invasive CPAP/BIPAP

X

Vital sign measurements

X

Advanced circulatory management (central line placement and removal, intraosseous lines, arterial lines)

X

CPR

X

Cardioversion

X

Arterial and venous sheath removal

X

Performs arterial puncture for ABGs

X

Epicardial pacing, assessment, and management

X

Permanent pacemaker (assessing function and management

X

12 lead EKG interpretation

X

Cervical spine trauma assessment for possible neurologic injury

X

Burn assessment and management.

X

Immobilization device application/management

X

Organ donation (identifying potential donors)

X

Intracranial monitoring (assessment and management)

X

Reduce dislocated joint

X

Remove foreign body (from ear, eye, nose, soft tissue, other)

X

Radiology reports (interpret CT, X-ray, and MRI)

X

Sedation (manages procedural sedation)

X

Chest tube placement, management, and removal

X

Compartment pressure measurement and management

X

Wound management (Stage 1–4 pressure ulcer management, incises/drains/debrides wounds, suture/steri-strip/dermabond use)

X

Digital nerve block

X

Thoracentesis

X

Epistaxis management/nasal packing

X

Performs gastric lavage

X

Nail bed closure

X

Nail trephination

X

Injects local anesthetics

X

· Presenting the history of a patient is an important tool in acute care settings. I have the skills and knowledge to interpret patient records. With the high demand for emergency care, I have mastered the CPR step-by-step guide and the skills and knowledge required to perform CPR on patients in emergency care to save their lives as they wait for emergency care to arrive.

· Similarly, I have the skills to manage wounds of all stages effectively. I have the capabilities and competencies to manage different types of wounds, including pressure ulcers, incises or drains, debride wounds, stature, and derma bond use. I also have exceptional epistaxis management skills using nasal packing based on medical situation demands, bleeding severity, and patient co-morbidities.

· I also have the capabilities and competencies required to identify potential organ donors. It is important to assess potential donors to ensure their lives will not be compromised when donating organs. I can write a radiology report with supervision because I am not confident enough to do it alone (Yan & Brown, 2017). I can interpret CT, X-ray, and MRI documents with the help of a supervisor and accurately present the findings.

· I can, without supervision, administer alternative drugs, especially inhalation and transdermal route drugs. I also have skills and knowledge in administering non-invasive ventilators to help with BPAP and CPAP health issues among patients. I can also confidently evaluate and asses vital signs (Koralakunte et al., 2021). I can measure heartbeat, temperature, blood pressure, and breathing rates, among other vital signs.

· I also have local anesthetics injection capabilities, so I can effectively work in theater to aid surgical processes. I can use my skills in local anesthetics injection to improve my wound management competencies in a clinical setting.

· The first opportunity I have to advance or improve my skills and knowledge in nursing is to further my academic career through higher education. Through higher education, I will attain skills, experience, and knowledge that are important in increasing my professional practice as a nurse.

· Although I have some skills in writing radiology reports, I have an opportunity to up my game in radiology report writing through higher education. I will focus on understanding how to effectively read and interpret X-ray, MRI, and CT images and documentation to attain a complementary level (Yan & Brown, 2017). I will use autonomic results and skills to interpret the medical images.

· From the assessment, I realized that I need to work hard to improve my skills and knowledge in chest tube placement, removal, and management. I will also focus on understanding compartment pressure measurement and management skills in advance of my training in nursing.

· Tuberculosis and respiratory infections are prevalent today. Therefore, I need to be skilled and experienced in gastric lavage procedures. I realized that my skills and competency in this area are wanting, and I can increase my knowledge in this area as I take advanced nursing training (Koralakunte et al., 2021). The ability to perform gastric lavage will increase my competency in testing respiratory infections.

Goal One: To ensure that I plan effectively on managing my academic needs and work without compromising my work studies.

Objective One: To identify my work requirements and needs and my training and academic career needs and plan on the best ways to balance the two variables.

Goal Two: Learn to read and interpret MRI, X-ray, and CT images to write competent radiology reports.

Objective Two: To learn more about how autonomics work from a clinical perspective to correctly interpret MRI, CT, and X-ray images and write the correct radiology report.

Goal Three: To develop the skills and knowledge required to improve my intracranial monitoring, assessment, and management capabilities.

Objective Three: Focus on understanding how IV mannitol, barbiturates, transient hyperventilation, hypertonic saline, and bed elevation work to achieve clinical management of ICP.