SMART Goals Revision / Reflection
ANSWER
The first SMART goal
Goal number one is to apply theory and skills in patient care.
S – I will put all of the theories and skills I learned in our block lab to use. I want to demonstrate a head-to-toe assessment to my patient because this will serve as baseline data for monitoring my patient’s progress. The instructor will allow me to practice various nursing skills that will be useful when I entered our first clinical setting in February 2019.
M – As we near the end of our clinical practice, I plan to review my nursing skills to ensure that I can safely perform the tasks assigned to me, such as the proper transfer technique. I should be competent and efficient, especially since I will be performing a quick prior assessment of our patients’ ABC (airway, breathing, circulation), vital signs, and pain assessment using the pain scale and LOTARP method, as well as pain management.
A – I want a positive performance evaluation in our clinical practice. I will devote at least 30 minutes to going over my notes, such as my student journal, and practicing the skills I need to improve to be confident in doing it.
R – I previously worked in a long-term care facility, so I am familiar with assisting clients with daily activities such as dressing and bathing. However, I still need to devote 50% of my time to learning the skills that need to be improved to continue to advance my knowledge and skills as a psychiatric nurse.
T – By the time we went for our first clinical experience in February 2019, I should be competent and confident in all the nursing skills I learned in clinical procedure one and older adult mental health theory.
My goal is to exhibit nursing knowledge: theoretical models of nursing, nursing skills, procedures, and interventions, which are stated in the 2.3 criteria (BCCNP, 2014).
SMART goal revision: By March 2019, I will apply and demonstrate the theories learned in conducting an extensive head-to-toe assessment in the older adult clinical placement.
Critical Thinking: I have not yet met my goal because my clinical placement has not yet begun. As a result, I plan to expand my knowledge through reading and practice. Our activity in our Health Care for Older Adults Clinical Practice course assisted me in gaining confidence in interacting with seniors and encouraged me to assess my proficiency in conducting a head-to-toe assessment. We interviewed a senior for the past two weeks to practice our assessment skills. I had the opportunity to demonstrate a comprehensive evaluation of the senior’s functional abilities and perform a quick prior assessment, including vital signs taking and pain assessment (Potter et al., 2014). I used the Katz Index assessment tool to determine whether a senior could perform daily activities. This tool was created on a 3-point scale to assist in scoring performance abilities as independent, assistive, dependent, or incapable of performance (Touhy et al., 2012, p. 213).
I will accomplish more in my upcoming clinical practice once exposed to the clinical setting. I plan to complete my goal by March 2019 and apply what I have learned about conducting a holistic assessment to clients.
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The first SMART goal
Goal #2: Become acquainted with and learn more about the patient’s cultural and religious beliefs, which may impact their care plan.
S – Because we live in a multicultural country, I must understand our patients’ cultural and religious beliefs. By February 2019, I will have read various articles on cultural diversity and multiculturalism. These resources will be used in my weekly forums as needed.
M – I am already aware of and familiar with the cultural and religious beliefs of patients from various cultural backgrounds before our clinical practice begins. I should be able to devise a strategy for dealing with these patients’ cultural beliefs about touch or eye contact. Moreover, religious beliefs, such as Jehovah’s Witness, decline blood transfusion because of their faith and religious practice (Chand et al., 2014).
A – I will spend one-hour reading articles about the aging process and cultural diversity, which will help me learn about various religious and cultural beliefs. I will also check various websites to see if any current news or research will inspire me to provide the best possible care for a patient with specific care preferences due to cultural or religious beliefs.
R – I am familiar with Asian and Indian cultures, but I would like to expand my knowledge of other cultural and religious beliefs. I will look for a community center that offers free learning sessions, particularly senior and recreation centers in my area.
T – By February 2019, I should be ready and confident to begin my clinical practice because I already have cultural and religious training in dealing with patients and providing the highest quality of care while prioritizing their safety.
As stated in the 5.3 criteria, my goal belongs in the core competency area of quality care and client safety, which incorporates cultural knowledge, security, and sensitivity. In addition, the 5.3.2 criterion states that discover the patient’s cultural needs, beliefs, practices, and choices (BCCNP, 2014).
By February 2019, I will have expanded my knowledge and demonstrated competency in assessing clients’ cultural and religious beliefs that may impact their care plan.
Critical Reflection: I achieved my goal because I recently worked with an older adult from a different cultural background than mine. I have also read articles about common cultural and religious beliefs among older adults, which we discussed in our Health Care for Older Adults Clinical Practice course. For example, a patient who is a Jehovah’s Witness may refuse a blood transfusion because of their faith and spiritual practice (Chand et al., 2014). I will be more aware of the situation as I read the care plan and ensure that I adhere to their preferences. Another example is for clients who have food preferences based on their cultural beliefs and practices; I have studied and comprehended a related article by Bermudez and Tucker titled, Cultural Aspects of Food Choices in Various Communities for Elders (2004). Eating habits are influenced not only by physiological necessity and food availability and selection but also by cultural standards, insights and information, and food access, which are frequently influenced by physical ability and economic circumstances (Bermudez & Tucker, 2004, p. 22). People eat to meet personal and biological needs, as well as a variety of other factors influenced by society and culture (Bermudez & Tucker, 2004, p. 22). According to Jones and Darling (1996), for immigrants from various ethnic communities, their traditional cultural food and the preservation of their traditional food-handling methods are both sources of convenience in a foreign environment and a means of preserving their cultural existence (as cited in Bermudez & Tucker, 2004, p. 22). Food has several implications for all cultural groups: Biological (food provides vital nutrients), health (healthy foods promote wellness), religious (some foods are treasured), and social (food aids in the preservation of traditions and social structure) (Bermudez & Tucker, 2004, p. 22). I will respect my clients’ cultural beliefs and practices. I have expanded my knowledge of different cultures by visiting local community centers and recreation centers and participating in learning sessions about multiculturalism. I have also read relevant articles about cultural diversity and multiculturalism, which I will use in my patient care and include in my reflective journal.
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The first SMART goal
Goal #3: Maintain a trusting relationship with other health care providers to improve the patient’s treatment care plan outcomes.
S – As future nurses, we must maintain good working relationships with other healthcare team members. When our clinical practice began in February 2019, I will develop trust with all of the team members I will be working with, including recreation and wellness therapists, dieticians, and the director of care to create an individualized nursing care plan for my future residents in the senior’s home.
M – Before beginning my shift, I will obtain approval from the nurses on duty and read the reports from previous shifts to know what has occurred over the last 16 hours.
A – I will set aside at least 30 minutes of my time to attend staff meetings and care conferences for patients so that I know any updates to the patient’s care plan. If there are any ideas that I can share, I will do so, and if there are any clarifications that I require, I will ask my colleagues.
R – I worked as a care aide and collaborated with all the nurses and other care teams to create the best possible care plan for the patients. As an aspiring nurse, I must collaborate closely with the entire healthcare team because we all have one goal: the betterment of our patients.
T – Following our clinical practice in April 2019, I will apply my experience working with all healthcare providers and ensure that I maintain the same attitude toward our patients’ well-being.
As stated in the 3.1 criteria for core competency area collaborative practice, my goal is to build and maintain professional relationships that improve patient care and continuity of care (BCCNP, 2014). Also, criterion 3.1.1 is to build and maintain relationships among team members through interpersonal communication skills (BCCNP, 2014).
Revised SMART goal: By the end of February 2019, I will work collaboratively with my clinical instructor and other care staff to maintain a good trusting relationship to have a better outcome for the patient’s treatment care plan.
I have not yet met my goal because I have only been in clinical placement for a week. However, by the end of February 2019, I should be able to establish trusting relationships with all the healthcare providers I will be working with, particularly my clinical instructor, to provide the best care plan for my client. Before my shift begins, I will review the collaborative care plan with the nurse on duty, and after my shift, I will report all pertinent information gathered and observed from my client. One important example of collaborating with the nurse is to keep them updated on the client’s daily status, such as their intake and output, if they have any complaints, any changes in their actions, and if there are any bruises or redness noted. Another example is the importance of working together to address the client’s behavior, such as a client who is verbally and physically aggressive. It is critical to inform the healthcare team about the client’s actions to reduce the risk of injury to the staff and the client. I will attend a care conference to discuss the client’s recent behavior, and the healthcare team will then devise a plan to control the client’s behavior. I plan to achieve this goal by the end of February 2019. I will work closely with the rest of the healthcare team, including recreation and wellness therapists, dieticians, and the director of care, to ensure that the clients receive safe and high-quality care.
References
O. I. Bermudez and K. L. Tucker (2004). Cultural aspects of food choices in various elder communities. 22-27 in Generations, 28(3). https://search.proquest.com/docview/212260497?accountid=195685 retrieved
The British Columbia College of Nursing Professionals. (2014). Entry-Level Competencies for Registered Psychiatric Nurses. Obtainable at: https://www.bccnp.ca/becoming a nurse/Documents/RPN entry-level competencies.pdf
N. K. Chand, H. B. Subramanya, and G. V. Rao (2014). Patients who refuse blood transfusions are managed. The Indian journal of anesthesia, 58(5), pp. 658-64.
Potter, P. A., & A. G. Perry (2014). Fundamentals of Nursing in Canada (J. C. Kerr & M. J. Wood, Eds.). Mosby Elsevier, Toronto.
T. Touhy, K. Jegg, V. Boscart, & L. McCleary (2012). Gerontological Nursing and Healthy Aging by Ebersole and Hess (1st Canadian Edition). Elsevier, Toronto, Canada.