NR 449 Week 1 Discussion: Clinical Decision Making

NR 449 Week 1 Discussion: Clinical Decision Making

Student Name

Chamberlain University

NR-449 Evidence-Based Practice

Prof. Name

Date

Introduction to Developing Self and Others

In nursing, professional growth is a continuous journey that combines personal ambition with structured career pathways. Nurses have ample opportunities to expand their skills, assume leadership roles, and achieve personal satisfaction through purposeful career planning. Career progression requires more than technical competence—it demands aligning professional goals with ongoing education, reflective practice, and mentorship.

Nursing leaders play a pivotal role in supporting this development by providing guidance, modeling ethical and professional standards, and fostering supportive learning environments for both novice and experienced nurses.

Through intentional learning and career planning, nurses can:

• Implement effective strategies for self-improvement and peer support.

• Differentiate between leadership and management roles within healthcare settings.

• Build and reinforce a strong professional identity.

• Apply Benner’s Novice-to-Expert framework for personal and peer growth.

Professional Career Advancement

Career development in nursing is a collaborative responsibility shared between the nurse and the organization. While healthcare institutions offer resources, structured opportunities, and educational programs, nurses must actively engage in shaping their professional trajectories.

Strategies for career advancement include:

• Defining clear short- and long-term career objectives.

• Participating in continuous education and specialized skill development.

• Cultivating and sustaining mentorship and networking relationships.

Leadership and Management in Career Planning

Leadership and management are both essential for nursing career growth, though their roles differ. Leaders focus on motivation, mentorship, and innovation, while managers concentrate on operational efficiency and policy adherence.

Comparison of Leadership and Management Functions

Functions	Leadership	Management
Encourages evidence-based skill-building	X
Allocates leave for training and education		X
Demonstrates commitment to lifelong learning	X
Creates pathways for career advancement	X
Implements transition-to-practice strategies		X

Benner’s Novice-to-Expert Framework

Patricia Benner’s framework outlines five stages of nursing expertise, guiding self-assessment and mentoring practices.

Stage	Description
Novice	Lacks clinical experience; depends on rules and guidelines.
Advanced Beginner	Possesses limited practical experience and requires supervision.
Competent	Demonstrates efficiency and effective task prioritization.
Proficient	Recognizes patterns and integrates holistic judgment.
Expert	Exhibits intuitive knowledge and advanced clinical expertise.

Professional Identity in Nursing

Professional identity represents the integration of ethical values, clinical knowledge, and long-term commitment to nursing. This identity shapes how nurses perceive themselves, interact with patients, and contribute to the profession (Rischer, 2021).

NR 449 Week 1 Discussion: Clinical Decision Making – Career Stages in Nursing

Career Stage	Description
Novice	Minimal experience; requires guidance and development.
Advanced Beginner	Applies guidelines independently in limited situations.
Competent	Prioritizes care effectively using accumulated experience.
Proficient	Recognizes patterns and applies holistic thinking.
Expert	Acts as mentor and manages complex patient cases.

Steps to Develop Self and Others

Nurses enhance their professional growth by progressing through structured stages while refining both clinical and interpersonal skills.

Stage	Description
Novice	Performs basic tasks but lacks contextual awareness.
Advanced Beginner	Follows protocols with guidance from experienced staff.
Competent	Delivers care efficiently based on practical experience.
Proficient	Applies holistic clinical judgment in complex situations.
Expert	Anticipates patient needs and mentors colleagues.

Succession Planning and Organizational Support

Succession planning ensures that future nursing leaders are adequately prepared and supported. Key strategies include performance evaluations, constructive feedback, internal job postings, and specialized leadership development programs. Aligning staff career goals with institutional objectives strengthens both individual and organizational outcomes.

Self-Development Framework

A structured approach to professional self-development includes the following steps:

1. Assessment – Identify personal strengths, interests, and areas for growth.

2. Goal Setting – Establish SMART (Specific, Measurable, Achievable, Relevant, Time-bound) goals for short- and long-term development.

3. Visioning – Define desired career trajectory and milestones.

4. Skill Building – Engage in continuing education, training, and mentorship.

5. Implementation – Execute the career plan with deliberate actions.

6. Review – Conduct biannual evaluations and adjust plans as needed.

Transitioning to Practice

The American Nurse Credentialing Center’s Practice Transition Accreditation Program® (PTAP) supports nurses in adapting to new roles.

Program Type	Description
RN Residencies	Designed for nurses with less than 12 months of experience.
RN Fellowships	Supports experienced nurses transitioning into new practice areas.
APRN Fellowships	Provides guidance for newly certified advanced practice nurses.

Success tips for new nurses include:

• Networking through professional organizations and events.

• Maintaining strong mentorship relationships.

• Practicing open communication with colleagues and preceptors.

• Engaging in lifelong learning and evidence-based practice.

• Prioritizing self-care and personal well-being.

Recruitment and Retention in Nursing

Recruitment aims to attract qualified nurses, while retention focuses on keeping them engaged and satisfied.

Description	Recruitment	Retention
Ensure qualified staff for positions	X
Prevent turnover		X
Coordinate staffing schedules	X
Monitor resignations and retention trends		X

Addressing the Nursing Shortage

The National Academies of Sciences, Engineering, and Medicine (2021) identify key contributors to the nursing shortage, including retirements, faculty shortages, high stress levels, and poor work-life balance. Solutions include promoting diversity, expanding educational capacity, strengthening workforce resilience, and addressing post-pandemic challenges.

Orientation and Onboarding

New nurse integration follows a structured three-phase approach:

Phase	Description
Induction	Pre-start introduction to organizational policies, benefits, and culture.
Orientation	Unit-specific training to develop competencies.
Socialization	Assimilation into team workflow and professional culture.

Lifelong Learning and Career Development

Continuous education enables nurses to remain competent, advance professionally, and provide high-quality patient care. Activities include pursuing specialty certifications, applying evidence-based practice, and engaging in professional networks.

Mentorship, Role Models, and Coaching

Type	Features	Relationship Type
Role Model	Inspires through example; impact may be positive or negative	Passive
Mentor	Provides formal, goal-directed guidance	Formal
Coach	Focuses on skill development; may be short- or long-term	Formal/Informal

Promoting Self-Care

The American Nurses Association Code of Ethics (2015) emphasizes the ethical obligation of nurses to maintain their health and competence. Effective self-care strategies include:

• Consuming a balanced diet and staying hydrated.

• Ensuring adequate sleep and restorative rest.

• Participating in regular physical activity.

• Seeking social support and engaging in leisure activities.

Conclusion

Nursing career development is a dynamic, multifaceted process that integrates planning, lifelong learning, mentorship, and self-care. By aligning personal goals with professional responsibilities, nurses enhance both their personal fulfillment and patient outcomes. Organizations benefit from improved retention, higher-quality care, and the cultivation of a culture of professional excellence.

References

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. https://www.nursingworld.org/coe-view-only

Buchan, J., Duffield, C., & Jordan, A. (2018). ‘Solving’ nursing shortages: Do we need a new agenda? Journal of Nursing Management, 26(4), 302–305.

National Academies of Sciences, Engineering, and Medicine. (2021). The future of nursing 2020–2030: Charting a path to achieve health equity. National Academies Press. https://doi.org/10.17226/25982

NR 449 Week 1 Discussion: Clinical Decision Making

Rischer, K. (2021). Professional identity in nursing: Strategies for success. Journal of Nursing Professional Development, 37(1), 10–15.

World Health Organization. (2021). Self-care interventions for health. https://www.who.int/news-room/fact-sheets/detail/self-care-health-interventions