The transferability skills in nursing are referred to as skills that are required to be present among nurses to make them successfully deliver quality care and improve their reputation along with well-being of patients. The nurses require wide number of transferability skills to be present, but they are learned at different level in the academic field. Thus, in this portfolio, the transferability skills learned at the graduate level are to be discussed initially to mention the way they can be implemented in the post-graduate study by useful purpose. For those seeking further assistance, nursing dissertation help can provide valuable guidance in developing these skills effectively. Thereafter, the sources of evidence and importance of evidence-based practice are to be discussed. The importance of resilience and self-management in nursing is to be discussed along with the way to improve myself to be professional on the course is to be explained. The future learning needs are to be identified and based on the identified needs, a personal develop plan is to be framed and discussed.
During the graduation level in the nursing professional, I developed wide number of skills and knowledge among which communication skill is the first skill I adopted effectively in the level. The presence of effective communication skill among the nurses is essential so that they can understand the way of developing interaction with any nature of patient both verbally and non-verbally. It is also essential for the nurses to identify the way to effectively interact with colleagues, multi-professionals, social care workers and others to establish enhanced intra- and inter-agency working culture (Shorey et al., 2018). I developed effective communication skills which are evident as I was able to form enhanced verbal and non-verbal communication with any patients to understand their needs and demands in care. It was beneficial as identifying the person-specific needs of patients helps in establishing person-centred care that provided high-value support to the patients compared to general care support (van Rijssen et al., 2019). Moreover, I expressed efficacy to form communication with colleagues and other professionals without hindrance while in practise placement during graduation ensuring I have enhanced communication ability.
The presence of improved communication skills at graduate level in the nurses can be applied in the post-graduate study to form enhanced leadership qualities. This is because enhanced communication skill makes the post-graduate nurses while acting as leader or supervisor to low-level staffs or nurses to form enhanced interaction with them to identify the resources and support they are to arrange which are their responsibility as a leader to support smooth flow (Prip et al., 2019). The communication skill could also be applied in the post-graduate to communicate efficiently with peers and lectures to discuss the problem in the study and consult ideas along with gather information regarding the way to accomplish the study in the best possible way by resolving the raised problem (Chan et al., 2018). In the practice placement during graduation, I was allocated to care for a patient with dementia who expressed immense anxiety and lack of compliance in care due to being shifted in new environment. In this condition, I expressed enhanced compassion and empathy towards the individual which led him to gradually comply with care. Thus, I have enhanced empathy and compassion skills which is important as compassionate skill helps the nurses to ensure less exhibition of anxiousness and improved self-control from the patients and empathic skill assist nurses in building trusting connection with patients (Percy and Richardson, 2018). The compassionate and empathetic skills are to be used in post-graduate study to keep myself calm and understand the way things are working to release the way to cope with any problematic situation.
During graduation, I expressed effective critical reflection skills which is evident as I always developed reflection of my work in a critical manner in the practice setting to determine the strength and limitation being faced during the entire event of care. It is evident as an effective critical reflection during caring for a COPD patient helped me identify that I have immense team working skill because I effectively establishing de-addiction services for the patient by working with social workers of another agency. As mentioned by Kim et al. (2018), critical reflection is important in nursing as it helps to provide deeper provision for the individuals to think differently to work out various obstacles and issues. This is because it assists in analysing the outcomes of practice to determine the aspects to be improved. Thus, the critical reflection skill is to be applied in my postgraduate study by using it for self-reflection. This is because it would help me to develop self-analysis and self-directed learning regarding the things to be improved for being a better-qualified professional who delivers enhanced quality care compared to others.
The appraisal of the current level of graduate skill indicated that I have effective team working skill which was identified during self-reflection of care of a COPD patient during my practice placement at the graduate level. As asserted by Dearnley et al. (2018), team working skills among nurses are important as they help in improving quality of care and lower stress among patients regarding the outcome of their health. This is because in team working, the nurses collaborate with the patients, their colleagues and other professionals to share and implement innovative ideas from different individuals in delivering enhanced quality care that satisfies the client as well as meet the care standards appropriately. The team working skill would be applied in the post-graduate study by using it to form group studies where sharing of ideas and discussion to resolve problems regarding different topics among teammates would be done to build enriched understanding and successful education of complex topic in the level. Moreover, application of team working skill in the post-graduate level is to be applied to form team with peers to explore the further career opportunities present for us to successfully play as affectionate nursing professionals.
The appraisal of current graduate skills indicated that I also have enhanced research awareness skills. This is evident as I was able to research regarding any unexplored topic given to me during graduate level in potential platforms, have ability to provide attention to detail, resolve problems regarding the topic through presentation of valuable information and derive valuable results from the research. It helped me explain many topics without the help of my lectures and assist me in executing evidence-based practice. This is because research awareness led me in the practice placement during graduation to understand which aspects of care valuable to be researched to draw evidence for use to ensure quality care is delivered to patients through evidence-based practise. The research awareness skills are important as it helps nurses to develop advanced and updated ideas regarding care in their field and offer better care along with it enhanced their information collection ability (Uysal Toraman et al., 2017). The research awareness skill is to be applied in post-graduate study by using it to explore valuable information for the complex care topic in the level and to established evidence-based practice in placement. This is because it would help me to resolve the barrier towards understanding complex topic at the level due to lack of presence of analytical and well-researched information ensuring my greater academic success.
During graduation, I developed enhanced conflict resolution skills. This is evident as in the practise placement during graduation, I was asked to care for a dementia patient who often developed conflict with the nurses that he is not been provided meal properly as a result of his forgetfulness even though it was provided to him. In order to resolve the conflict, I asked me supervisor if I could include a personal meal chart for the patient where he would sign each day after meal to ensure he was provided food and avoid raising conflict with the nurses. The idea was also consulted with the patient and both him as well as supervisor approved off the strategy of conflict resolution which was found to be fruitful in limiting the conflict. The conflict resolution skill is to be applied in the post-graduate level by using it to limit conflicts between teams and patients with nurses. The skill would be used to educate myself regarding the way to accommodate in the competitive condition in the study group so that no conflicts are raised that would disrupt the team performance.
The evidence-based practice or care (EBP) is the inclusion and integration of best clinical and scientific evidence for imparting high quality care that ensures the value of the patients with high care satisfaction in them (Alving et al., 2018). The filtered sources of evidence in EBP include conference proceedings and clinical discussion in which clinical experts along with subject specialist develop a question and based on the query synthesise evidence through discussion and interaction for stating conclusion regarding any special care delivery. The sources are helpful because the developed facts are searched, and the results presented are evaluated to offer answer to any clinical problem in care (Camargo et al, 2018). The unfiltered sources of evidence include primary and secondary science articles and journals gathered from platforms like CINHAL, MEDLINE and others. The academic publications are considered as the best quality of evidence source for framing EBP as they are easily available and present detailed explanation along with analysis of any nursing practice in logical way through scientific methods and experiments. It leads the nurses to understand the way the evidence-based practice would affect patients in real condition and the precautions along with skills are to be developed by the nurses to impart enhanced care (Mohanasundari and Padmaja, 2018).
The clinical experience is another source of evidence in EBP where the knowledge and life experiences in delivering care from senior professionals are used as evidence by the junior or new nursing individuals (Bianchi et al., 2018). The other common sources of evidence used in developing EBP by nurses are patient records or patient case study, clinical and nursing books, news report, nursing websites and others (Horntvedt et al., 2018). The books, conference records and news report act as source of evidence in which the data regarding nursing ways are presented in subjective and theoretical manner that leads nurses to develop theoretical ideas of way to impart effective EBP to the patients (Mohanasundari and Padmaja, 2018). The patient records act as source of evidence in executing EBP by presenting the care delivery ways, knolwdege of different professional practise, control of social and physical life of patients and others to be used in easier and error-free treatment of similar patients (Camargo et al, 2018). The social and professional network, informative feedback from patients, local and national care policies and guidelines, audit and performance data, patient narratives and others also act as potential source of evidence to be used in framing EBP (Mohanasundari and Padmaja, 2018).
During the final year of Health Promotion and Public Health studied at the University of West London, I learned brief regarding EBP and its importance in nursing field. One of the importance of evidence-based practice is that it enables nursing practitioners to get better information regarding the way to perform their duties and responsibilities of care towards the patients (Birken et al., 2018). This is because evidence in EBP mention in detail the way of performing any complex care, risk to be faced by the patient and professionals in performing them, skills and knowledge required in nursing, way to overcome the risk and barriers to be experienced, success rate of the intervention and others. The information is strategically used by the nurses which helps them in clearing their doubts and develop confidence to execute their duties and responsibilities in effective manner (Li et al., 2018). The study by Dikmen et al., (2018) argued that key importance of evidence-based practice (EBP) is that helps in creating improved patient outcomes. This is because evidence in EBP acts as effective informative assistance for the nurses and other healthcare practitioners to develop enhanced focus and confidence out of better knowledge regarding the care practice. It leads them to raise the overall quality of care by minimising complications that are associated with care delivery regarding chronic and acute diseases of any nature (Fiset et al., 2017).
The significance of evidence-based practise is that it helps in creating client-focussed care for the patients. This is because in EBP the nurses who already have understanding of the needs and concerns of the patients are seen to identify evidence in meeting the raised demands of the patients and develop client-centred care decision as required for the beneficence of the patient (Dikmen et al., 2018). As argued by Mathieson et al. (2019), lack of client-centred care leads to create dissatisfaction among the patients regarding the delivered care. This is because of the lack of value towards them expressed during the support and avoidance to meet their needs regarding care. Therefore, EBP is important to be included in delivering enhanced care to the patients. The other significance of EBP is that it enables to ensure consistency of care which is essential to be established for maintaining optimal health of the patients along with minimise chances of error (Bialous et al., 2017). The consistency in care is achieved when determined quality is reached every time of delivery of the care support with less error being faced during its delivery to the patients. In EBP, the evidence helps the nurses have written or theoretical guidance regarding specific way a certain care is to be delivered with high quality and consistency which they followed to ensure uniformity of the delivered care (Grove and Gray, 2018).
The importance of EBP is that it helps in creating structured process of care delivery and lower the cost of overall care support for the patient. This is because EBP helps the nurses have information regarding the best care to be delivered that assures least chances of readmission due to relapse of health condition of the patients out of error in care which raises the overall cost of care (Saunders and Vehviläinen‐Julkunen, 2017). As argued by Stavor et al. (2017), increased cost of care leads the economically poor individuals to leave accessing clinical support in the middle of the treatment causing incomplete care delivery. This would make many individuals to suffer negatively from their health condition with relapsed cases and increased mortality. Thus, EBP is important in nursing care to practise to be involved.
The other importance of EBP is that helps in creating superior nursing skills. This is because incorporation of EBP in the education of the nurses along with their clinical experiences leads them to develop enhanced critical thinking and decision-making skills. The EBP is important as it allows nurses to develop better adaption to complex care situation, strategically utilise their informatics and work with inter-disciplinary team (Jamieson et al., 2019). The EBP is also important in helping nurses identify the way of participating in future nursing researcher that are essential for the upliftment of existing care for the patients (Saunders and Vehviläinen‐Julkunen, 2017). The EBP important as it avoids inappropriate use and exploitation of resources in nursing care. This is because evidence mentions amount and nature of specific resources needed and way to strategically use them while accessing from sources to ensure quality care delivery by nurses (Saunders and Vehviläinen‐Julkunen, 2017).
The resilience is considered as an imperative quality of the nurses as they have stressful nature of working for which without being resilient they would lead their emotions to be challenges which would negatively affect their working ability (Mathad et al., 2017). As asserted by Li and Hasson (2020), resilience in nursing is important to make the nurses develop less stress disorder and remain mentally healthy to work effectively. This is because resilience leads the nurses to show lesser emotional challenges and setbacks which makes them adaptive to complex stressful situations such as adversity, tragedy, trauma, threats and others at the family as well as at the professional level. As argued by Amsrud et al. (2019), lack of resilience in nurses makes them face emotional turmoil which led to hinder their performance at work. This is because without resilience the nurses become emotional on each aspect of care which makes them rude, impatient, lack confidence and others that are violated rules of care.
The resilience among nurses is important because it helps them to accept as well as adapt to any complex situation to move forward towards delivery care as their key responsibility. This is essential to maintain continuous and uninterrupted flow of care to patients from the nurses irrespective of any complex condition (Thomas and Asselin, 2018). As argued by Mathad et al. (2017), lack of resilience among the nurses would make them feel helpless which may lead them to rely on unhealthy coping strategies such as use of drugs and others. This would disrupt their effective way of executing their duty by being sober and constrained, which in turn, may make them lose their job or perform major error in care that creates adversity to the health of the patient. Therefore, resilience is important for the nurses to remain strong and act as effective support system as expected of them to ensure well-being of the patients.
In contrast to resilience, self-management is the development of ability of the individuals to prioritise goals for deciding what is to be done and way to be accountable for completing the necessary action (Öberg et al., 2018). The importance of self-management for nurses is that it helps them develop enhanced personal focus towards their work and formulate own plan in meeting the determined vision and goals of care for the patient without assistance. This in turn makes the nurses feel empowered and have efficiency to be independent in delivering care to the patients without interference while assuring enhanced well-being of the patient too (Slev et al., 2017). As argued by Padilha et al. (2018), the lack of self-management skills in nurses makes them incapable to make efficient contribution to healthcare delivery. This is because without the nurses being able to self-manage their problems at work, they would always require assistance from others that may not available immediately. It would lead then nurses to lag in delivering timely care and save time for critical thinking to develop new personal strategies to be followed by others in support high-quality care delivery to patients (Öberg et al., 2018). The self-management in nurses is important as it influence resilience of individuals regarding complex situation. This is because self-management makes the nurses develop prominent and well-developed working strategies to personally control emotions, overcome complex situations, threats and others to be resilient to avoid any negative condition to hinder their stable emotional health (Öberg et al., 2018).
The building and promotion of self-resilience is one of the strategies to be applied in developing me as a qualified professional on the course. This is because resilience helps nursing professional in any course to develop enhanced mindfulness which assists them to make critical thinking to understand the way activities are to be performed so that they do not violate professional values which are to be respected at any point in nursing (Thomas and Asselin, 2018). Thus, through self-reliance, I would be able to understand way to avoid problem and barrier to personal influence in the course along with avoid them to influence me from violating professional values. This in turn would ensure my ability to maintain professional integrity in the course to be effective professional in completing it. The establishment of self-care is to be made by me to be self-resilient towards any actions. This is to be made through inclusion of improved self-care so that my negative emotions are effectively managed to avoid their influence to deter my motive of becoming best nursing professional in completing the course. The self-resilience among nurses are built through presence of positive purpose and relationships (Thomas and Asselin, 2018). In contrast, negative purpose and relationship leads the nurses to fail to become effective professional in the postgraduate course because they are influenced by external factors and react to them to deviate from their goal. Thus, promotion self-resilience is to be made through self-awareness, self-care, positive relationship and mindfulness in me to be become eligible professional for the course.
In order to become a qualified professional on the course, one of the strategies is that I have to develop enhanced research awareness. This is because research awareness helps individuals indenting to become successful nursing professionals in any course to have the capability in identifying all nature of odd and required evidence needed in completing the course (Uysal et al., 2017). Moreover, the building of research awareness would allow me to be capable of effectively performing evidence-based practice that is essential to be present as a professional skill in nursing intending to grow further in their career. The research awareness is to be built by organising required resources in the course, encouraging prioritisation of topics of care and others (Zwakhalen et al., 2018).
Another strategy to be applied for developing myself as professional on the course is involving extensive self-management of priorities and tasks being provided to me in completing the course. This is because it would ensure I have effective ability to use cognitive, emotional and behaviour management actions to maintain a satisfactory quality of professional life. The other strategy to become effective professional on the course is initiating to volunteer for other post-graduate experienced nurses to understand the effective skills needed for being the best professional on the current post-graduate course. This is because volunteering helps individuals to learn various aspects of any care or course before their actual involvement in the activity which offers the individual opportunity to develop learning regarding the way they are to act professional while being realistically involved in the situation or course.
The personal effectiveness as future nurse is important for me to show that I have capability to effectively accomplish goals and efficient in producing valued results with little wastage of effort. In order to develop personal effectiveness as future nurse, an individual require to seek and work on them to positively to feedback and support care of the patients that later ensure personal effectiveness as improved quality nursing professional. In my practise placement during graduation, I was allocated to care for a dementia patient who previously expressed being in conflict and argument with all nurses allocated to him till now as many of them avoided to pay regard towrads management of his plea. He reports care needs such as meals are not provided regularly even though they are been provided as he forgets the actions done as a result of memory problem due to dementia.
During his care, I also faced the similar negative behaviour from the dementia patient. However, in coping with this condition, instead of getting into conflict with the individual, I developed a meal chart to be signed by the patient after each meal to be later used as proof to ensure he is been provided food which he thinks has not been provided. In addition, I also tried to act in empathetic and compassionate manner to explain to the individual the cause of his hindered thinking and the way he can improve it by cooperating with the current care been provided. It helped me in creating positive support for the patient which is evident as positive support in nursing includes person-centred care and limitation or reduction of aversive behaviour which are achieved through the current care. Moreover, positive support has been provided to the patient as he never reported further disapproval of other care and increased his cooperation towards treatment been provided by other nurses. It led me to develop personal effectiveness as future nurse as in further care I would be able to avoid conflict with the patient and ensure delivery of positive support with effective compliance in care from the patients to deliver quality care that is the goal of my profession.
In the practice placement, I expressed effective ability to seek feedback from the patients and my colleagues. This is evident as I personally asked the dementia patient as well as his family to provided feedback regarding my efficiency to support the patient. In this regard, they submitted the feedback to my supervisor. Moreover, in the placement, I accessed personal feedback from my supervisor and colleagues by asking them to inform it through one of the feedback forms developed by me. I also accessed verbal feedback from my supervisor in the practise placement at the end of each week to determine the way I can manage my progress while working as registered nurse in future. The availability of feedback acted as support for my development of personal effectiveness as future nurse. This is because based on the feedback I identified the flaws and weakness to be improved along with the strength in skills I have that can be used for building my personal efficiency to work as a nurse in future.
During the care of the dementia patient, I developed confusion regarding one of the doses of the medication and its name provided to the patient. This is because the information written by the physicians regarding the medication was unable to be read by me due to hindered handwriting of the physicians. I developed doubt whether to ask for assistance or administer any medication that could be identified from the writing by me as requiring assistance was time-consuming at the time which may lead to delay the use of medication. However, I understood that to avoid medication error, I need to access the assistance in understanding the specific medication is and exact dose written on the prescription from the physician. Since the physician was not present at the hospital at the time, I called the doctor to which he calmly replied to help me and asked me to send a screenshot of the prescription so that the individual can confirm the medication and dose to me. The process took some time and it led me to delay the medication time of the dementia patient by 30 minutes. As a result of the delay, the patient expressed being angry towards me for not taking his timely care.
During providing medication after confirmation from the physician to the dementia patient, I apologised for being late and informed him in detail of the reason behind the unavoidable delay. The patient though was initially reluctant about the situation on listening to the reason showed acceptance and took the medication without causing any hindrance. After administering the medication, I ensured the patient that no further delay in care would be anymore be experienced by him as would remain more alert. This led to create positive care support towrads the patient as the flaw in care was explained along with the reason behind it rather hiding the fact which would lead to violate trust of the patient. The positive support also led me to develop personal effective as future nurse to understand the way delay in care is to be managed and the way patient is made to accept the condition with reason rather than provoking them to show mistrust regarded care ability towards the nurse out of sudden delay in care.
In another instance, while caring for a COPD patient in the practise placement, the individual initially informed that he does not wish to visit the de-addiction centre that was reported to be allocated to him to be effectively able to quit smoking. He informed that he is capable to personally control smoking and would try to cease the action. Instead of forcing him to join the centre, I politely and calmly mentioned to the COPD patient regarding the different activities he would be involved in the de-addiction centre and the way they are beneficial in improving smooth cessation of smoking in a limited time. I also informed him of the way he can be provided personal assistance at home and its importance for quitting smoking if he wishes to avoid availing of the care as mentioned in the centre. I provided him autonomy to choose the different care available for him and their risk along with significance towrads supporting his current health improvement regarding COPD. On the basis of the information, he personally provided consent to go to the de-addiction centre for smoking cessation which was previously refused by him as he mentioned it is more enhanced and supportive way to quit his habit. The positive support towards the patient to be autonomous in taking own care decision instead of forcing him to accept care was improved personal effectiveness that would help me as a future nurse. This is because promoting autonomy of patient during care creates enhanced nurse-patient relationship along with show value towards patient’s opinion to make them show effective compliance in care.
In my profession, one of the future learning needs is efficiency to use information technology to execute nursing practice. This is because in the 21st century it is seen that advancement in medical field has led to increased use of information and communication technology for practising nursing care in all aspects of care support (Kim et al., 2018). In the current condition, I lack the skill which is evident as I lack knowledge regarding the way to use many of the information technology used in nursing such as telehealthcare applications, electronic health record management and others. As mentioned by Isaiah et al. (2019), information technology in the current nursing field are important as they facilitate faster and easier flow of nursing information and ensure greater patient safety. This is because use of information technology leads the nurses to effectively document care and develop instant as well as early communication with professionals to resolve their problem in care so that risk for patients are avoided. It results in protecting the patients and ensure them greater quality care. Thus, I need to learn regarding the way information technology and devices are to be used to be able to deliver smooth nursing care.
The other future learning needs to be focussed is improvement of my intercultural sensitivity and problem-solving needs. I currently lack the skill which is evident as I failed to provide effective culturally sensitive care to one of the Muslim patients who was admitted to my practice placement. It led me to be replaced by another student nurse who expressed better knowledge regarding cultural sensitivity management. Intercultural sensitivity is important need for the nurses to manage as it is related to the culture and custom of the patient which differ from person to person across various cultures in societies. The failure to manage effective cultural sensitivity by nurses leads the patients feel disrespected by the nurses and it intends them to show non-compliance in care and develop conflict with the nurses out of not valuing their cultural principles (Arli and Bakan, 2018). However, it is argued by Çiftçi et al. (2021) that effective cultural sensitivity management by nurses helps them to create enhanced cross-cultural relationship with the patients. This leads the nurses to care for the patients of any culture with increased compassion and competence along with enhanced compliance from the patients out of their cultural attitudes been respected during support (Aktaş et al., 2019). It would also help to meet the NMC Code of conduct that mentions cultural sensitivities are to be considered during communication with the patients in care to make them respond in better manner to the nurses (NMC, 2018).
Problem-solving is important skill in the nursing field that is to be learned by the nurses as future need because it helps the nurses to personally resolve barriers faced in care to delivery it smoothly and without error (Durmaz et al., 2018). The other future learning needs is risk assessment and management of the patients in care. I currently lack the skill which is evident as one of the elderly patients under my care was seen to had risk of fall that was not timely detected by me and it led me to fail to be provided appropriate support for preventing his fall. The fall faced by the patient was not minor and he hurt his elbow, but the fall led him to face dissatisfaction with my care and ask for a replacement. The presence of effective risk assessment and management skill for nurses is important as it helps them to assure safety from any risk to patients during care which assists them in delivering improved quality support to the patients (De Meyer et al., 2019).
Another future learning need identified for the nurse is effective team management ability. This is because enhanced team management in nursing helps to create a collaborative relationship between different nurses which assist in sharing innovative ideas re resolve concerns at work and ensure quality care to be delivered (Ellis, 2018). Moreover, team management is required to be improved by nurses as future need because it helps them to develop ability to organise and coordinate a group or within a group to perform tasks that indirectly help them in forming better leadership in the later stage (Dickson et al., 2018 As a nurse, another future need to be focussed is ability to meet professional values and effective planning of care. This is because professional values are important to be followed by the nurses to delivery seamless care that also is legally and morally right to be delivered to patients (Ellis, 2018). Moreover, effective learning of the way of care planning assists nurses to deliver the best care at less cost to the patients along with ensures their enhanced well-being (Ellis, 2018).
The graduate skill to be applied at the post-graduate level are research awareness, accountability, enhanced communication and others. Evidence-based learning is important to create an enhanced patient outcome, improve care quality, reduce care costs and others. Resilience is important among the nurses to have a stable emotional condition in executing work and delivering quality care. Self-management is important for the nurses to be personally organised and able to arrange required resources and use them in providing quality care top patients without help or assistance from others. The future learning needs to be developed are Understand using information and communication technology, intercultural sensitivity and problem-solving, risk assessment and management, care planning and team management and leadership.
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