Running head: PGC REFLECTION 1

Program Graduate Competency (PGC) Reflection

Tracey A. Wilson

Department of Nursing, Delaware Technical and Community College

NUR 460: Nursing Capstone

Dr. Karen Wagamon

April 22, 2021

Program Graduate Competency (PGC) Reflection

In January of 2017, I had just turned 50 years old and was starting to realize that I needed

to go back to school to earn my BSN. It was becoming quite evident that if I wanted to advance

my career in nursing, I needed to do more. The thought of having to go back to school was scary

and I felt that I was a good nurse with the degree that I had, nevertheless, I enrolled in the new

RN to BSN Program being offered by Del. Tech. The journey has been long with a few bumps

in the road, but it has been one that I do not regret, and it has taught me more about the field of

nursing than I had expected.

All programs have objectives, goals, and competencies that establish what will be

developed and learned. Each course within the program builds upon the other until we reach the

final course where we must put everything we have learned together. The RN to BSN program

has 9 Program Graduate Competencies which we have been developing throughout our journey.

Each class we have taken has added another piece to the puzzle with the finished product being

displayed through the E-Portfolio. It is time to look back at all the work done thus far. Have I

met the standards, achieved my goals, and developed the competencies needed to transition from

RN to BSN?

Coursework and PGCs

General Education

General Education courses are required in all degree programs. They lay the foundation

for what will be expected in future courses. PGC#1 is to integrate general education knowledge,

skills, and aptitudes to advance nursing education and growth in professional practice. Let’s see

if we hit the mark. General Psychology gave us a better understanding of human behavior,

emotions, and how we respond to circumstances and the environment. Technical

Writing/Communication prepared us for all the papers that would be written in every course.

Ethical Issues in Health Care reinforced the principle of practicing nursing within an ethical

framework and showed that not every situation has a clear-cut solution. There will be gray areas

that will challenge our thinking, morals, and values. We must do what is good and right for the

patient. Disease Process/Pathophysiology taught us about many of the diseases that afflict so

many of the patients we take care of. When we understand the disease process, we can better

educate the patient on treatments and medications. Statistics I introduced an aspect of Math that

is used largely in research studies and then there is World History II. Through studying history,

we begin to understand a particular culture’s trials and tribulations, their struggles, and any

trauma that may have been experienced and how we need to conduct ourselves to avoid conflict.

History shows us what worked and what did not. Spanish for the Healthcare Worker was the

elective course I chose. It is important that we communicate to our patients clearly in a language

they understand. Aside from English, Spanish is the most common language spoken by an

estimated 38 million people in the U.S. (Meddeas, 2021). I will not light the world on fire with

my ability to speak Spanish, but I can read it and conduct an interview to gather a health history.

Nursing Courses

Once the general education classes are completed, the nursing courses begin, and we

discover the many facets of nursing. The first class we all start off with is RN to BSN Transition.

As an introduction, we learned about nursing theories, conflict management styles, personality

types and how they communicate, as well as establishing a life-long learning plan and a nursing

philosophy. In looking back at my work, I identified with Hildegard Peplau’s Theory of

Interpersonal Relations and the 7 nursing roles of stranger, resource, counselor, surrogate, active

leader, and technical expert (Petiprin, 2016). My philosophy of nursing then and now is to
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always show compassion, caring and respect. Demonstrate kindness and fairness. No one

person is better than another and all patients are to be treated equally. Always search for

knowledge then teach others what you have learned and know.

Health Assessment had us look at the whole person, body, mind, and spirit. Writing a

plan of care involved identifying problems, establishing goals, outcomes, plans and

interventions, follow-up evaluations and the use of community resources and referrals. PGC #7

is to integrate health promotion and disease prevention practices to positively impact the delivery

of healthcare to diverse populations. At this stage, I was only working with one person, but could

see how this plan could apply to many.

We move on to Global Health and Population and Community Health where PGC #7 is

demonstrated again. Growing up we live in our own little bubble, not really knowing what is

happening past our own front door. Global health is important and really does affect everyone.

Diseases we never heard of or thought could get to us are now spreading rapidly, so what

drastically affects one nation will eventually affect others. The year 2020 has shown us just how

small the world really is and how quickly a virus can shut everything down. In Population and

Community Health, my chosen population was adults 65 and older in Newark, DE with the

biggest concerns being chronic diseases, falls, and loneliness/isolation. As practicum

experiences were not available due to the pandemic, research was done comparing Pennsylvania

and Delaware COVID statistics, mandates, and the effect of the restrictions on my chosen

population.

Nursing Informatics brings the worlds of computer technology and nursing together with

the goal of promoting efficiency which in turn can cut costs and improve patient care quality. I

looked at Operating Room delays and the impact they have on hospital costs, patient, and worker
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satisfaction as well as patient safety. With the use of technology, large amounts of data can be

collected. As we sift through the information, we begin to see the issues and can start to

establish new programs to reduce and even eliminate the problem. This incorporates PGC #4

which is to integrate information management technology to improve patient outcomes.

Nursing Leadership explained the difference between leadership and management.

Managers are concerned with the work and how it is going to get done. They manage the

situation and the people. Leaders quite simply lead. They require followers, those that believe

what is being said or demonstrated. They inspire the people and change (Finkelman, 2016). Just

because you have a title or position does not make you a leader and leaders do not really need

titles. Leadership theories and styles were discussed and identified with PGC #2, demonstrating

leadership skills to promote patient safety and the delivery of high-quality healthcare, being

highlighted.

PGC #5, to advocate for patients and the nursing profession with regard to healthcare

policy at the local, state, national and global levels, was presented in Nursing Policy. I looked at

the physician shortage, nurse practitioners and full authority practice laws. It is projected that

the U.S. will have a shortage of up to 122,000 physicians by 2030 (Heiser, S., 2019). Many bills

and programs are being passed and established to help with this issue, but this takes time which

we may not have. A more immediate solution can be found with nurse practitioners and full

practice authority laws. With full practice authority, nurse practitioners could improve healthcare

access by working in new communities, rural and underserved areas where patient demand is

high (Thomas, S., 2019).

Nursing Research had us look at a healthcare issue and apply skills of inquiry, analysis,

and information literacy to support evidence-based professional nursing practice (PGC #3). My
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topic was Surgical Site Infections. As I have worked in the Operating Room and Sterile

Processing Services, I wanted to link the two areas together. My research questions were: What

if surgical instruments were not cleaned properly? How many cases of SSIs have been linked to

contaminated surgical instruments and what can be done to help eliminate this? Since these

infections are still occurring, are there further guidelines or protocols that nurses can implement

to prevent SSIs? Through literature review, looking at qualitative and quantitative research,

some questions were answered, but ultimately more studies need to be done.

Practicum Experiences

Practicum experiences give us the opportunity to put course material together and

observe someone working in the field of Population/Community Health and Leadership.

Unfortunately, due to COVID-19, I did not have an in-person practicum experience in

Population/Community Health. Research was done and a questionnaire was developed to

evaluate what barriers the community group was experiencing during the pandemic and how

they were adhering to the mandates and coping with the changes. Telephone interviews were

conducted, data was analyzed looking for barriers adults 65 and over were up against and what

could be done to help overcome those barriers.

For Nursing Capstone, the practicum experience was different. Luckily, I was able to

conduct an in-person practicum experience at the Wilmington VA Medical Center with the

Perioperative Services Manager. Every morning, meetings were held with staff, management,

and executive leadership where information was shared on issues such as admissions, discharges,

staffing and facility problems (PGC #2). A new Vascular Program is being established which

requires interprofessional communication, collaboration, and delegation (PGC #6). Data is

collected and looked at for quality reporting through the National Surgery Office. An ethical
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issue arose between getting high scores on a report with high overtime cost and potentially poor

staff performance versus low scores on a report with high performance, room utilization and

patient safety which bring in PGC #8, practicing professional nursing within an ethical

framework. In-services and educational presentations are scheduled on Microsoft Teams at the

VA. During my practicum experience, Proficiency Writing was presented giving instructions and

guidance on how to write staff proficiencies and performance standards as part of the yearly

performance appraisals. This is an example of demonstrating lifelong learning that empowers

personal and professional growth which is stated in PGC #9.

Course Goals

During the first few weeks of Nursing Capstone, we were asked to do a SWOT analysis

looking at our strengths, weaknesses, opportunities, and threats and then to establish course goals

outlining what we wished to accomplish upon completion of the course. In reviewing the

assignment, I had written 5 goals for myself. Now it is time to see if I completed what I set out

to do.

Goal 1 – Complete 45 hours of an in-person practicum with a preceptor at the

Wilmington VA with the Perioperative Services Nurse Manager within 5 to 6 weeks (8 to 10-

hour days) by week 12 of the NUR 460 course. I can proudly say that I did indeed have an in-

person practicum. It took a bit of work to get the legal agreement between the college and the

VA and there were moments when I thought I would be writing another COVID research paper,

but everything worked out in the end.

Goal 2 – During the practicum experience, explore how new information management

technology is being used to help improve patient outcomes/employee engagement. The VA uses

many different computer applications to capture information for staffing, attendance, leave
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requests, overtime, and work schedules. There are also two components to the electronic

medical record, CPRS and Vista. All the programs serve a particular purpose and are great in

and of themselves. The problem arises in the fact that they do not communicate with each other

so it can be labor intensive doing data entry.

Goal 3 – Investigate how collaboration, communication and advocacy was used by

nursing leadership to establish the COVID vaccination clinic within the Wilmington VA. I set

this goal in the event that I did not get the opportunity to take part in an in-person practicum.

This goal remains unmet as I did not have to use it.

Goal 4 – Collaborate with students in my group for the week 5 and 7 assignment and

allow tasks to be delegated out knowing that I can count on others to complete their part through

e-mail communication, discussion, and presentation. It was found in my SWOT analysis that

one of my weaknesses was the fact that I am reluctant to delegate, and afraid things will not be

completed on time. I need to let go and allow others to help complete assignments. I really tried

to do this; however, some members of my group were not cooperative and there was a

breakdown in communication. To complete the assignment, I took on the role of leader, had to

be a little tough in email communication and turned in the assignment with about 10 minutes to

spare. This was nerve-wracking, a bit too close to the deadline for me and definitely a learning

experience.

Goal 5 – Research Master’s Degree programs in Nursing Leadership, cost, time

commitment, and scholarship opportunities at the VA and incorporate findings in my life-long

learning plan by week 11 of the course. As I outlined in my Lifelong Learning Plan, I will be

looking into programs offering MSN – Nurse Executive, MSN – Nurse Leadership, or

MSN/MBA Dual Degree. There is a scholarship program offered at the VA with applications due
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in March and October. After a celebratory get-away to Disney World, I will continue my search

looking at local programs and online options.

Conclusion

Did I get everything done? Were all 9 competencies highlighted? In my opinion, the

answer is yes. Believe it or not, the Program Graduate Competencies were woven throughout

the program with little pieces appearing in each course we took. Some were obvious and others I

had to dig a little deeper to find. In looking back at all the classes taken and the many

assignments and papers completed, it has been quite a journey. There were times when I was

excited and loved what I was learning and times when frustration caused me to stop, almost to

the point of quitting. I eventually had to put on my “big girl” pants and finish what I started, and

I am glad that I did. I have made it to my destination; however, I am not finished. There is more

to do. I might be 60 by the time I get my next degree, but as they say, you are never too old to

learn.
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References

Finkelman, A. (2016). Leadership and Management for Nurses: Core Competencies for Quality

Care. 3rd Edition. Boston, MA: Pearson Education, Inc.

Heiser, S. (2019, April 23). New Findings Confirm Predictions on Physician Shortage. AAMC,

Association of American Medical Colleges. https://aamc.org/news-insights/press-

releases/new-findings-confirm-predictions-physician-shortage

Meddeas. (2021). More People will Speak Spanish in the US than in Spain. Meddeas Language

Assistant Blog. https://www.meddeas.com/blog/learnspain/spanish-us/

Petiprin, A., (2016). Hildegard Peplau – Nursing Theorist. https://nursing-theory.org/nutsing-

theorists/Hildegard-Peplau.php

Thomas, S.L. (2019, September 10). AANP president weighs in on full practice authority laws.

Nurse.com. https://nurse.com/blog/2019/09/10/np-share-insight-full-practice-authority-

laws/