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Nursing, just like any other profession, requires developing all the skills needed and learning various techniques of working. This implies that nurses have to possess sufficient knowledge that addresses various activities, which surround nursing as a profession. However, the status of competency is not attained that easily, as nursing is a complex discipline that cannot be approached as if it was just an applied field (Benner et al., 2009). This is perhaps the reason why many health organizations and regulatory authorities have put the benchmark of competency at quite a high level.

Human life is highly valued, and it can be put in danger if an individual who falls ill is not given an adept nursing care. Therefore, only the best knowledge and skills should be applied in order to safeguard human life and improve longevity. In this regard, a competent nurse hast to develop personal guidelines that will enable him or her to offer the best services to patients and build the prospects in the practice of professional nursing. This paper presents personal early career experiences in the field of nursing with a major focus on cardiac clinical nursing.

Current Clinical Specialty and Scope of Practice

The field of nursing is usually treated as rather general with many people assuming that a nurse can virtually work in any situations. Although such assumptions may be correct due to the commonality factor in training, there is no doubt that a nurse can specialize in the field of interest. This implies that one is engaged with a specific type of care, which is differentiated from the other types by the kind of ailments of the patients one is serving. The clinical specialty and scope of practice that I am interested in is cardiac clinical nurse specialist. According to Lorraine & Schnell-Hoehn (2010), there are conspicuous care gaps in the management of cardiac patients (p.76). This makes cardiac clinical nurse specialist critical in developing and implementing different techniques that best suit this group of patients. In addition, this class of nursing requires that tools used for the care were evaluated frequently enough to make sure that there is maximum evidence informed treatments that will serve a patient in the best way possible. This means that being a cardiac clinical nurse specialist requires using clinical evidence, as witnessed in the real world of practice.

Indeed, various tools, such as clinical pathways have been used across the world to equip nurses with the necessary skills and techniques for care improvement. My current practice is general, but tends to be related to the different ways of using tools in order to attend to patients with heart problems. Given the fact that heart related illnesses are highly critical and risky, such approach is particularly helpful in a number of ways. First, the nurse is able to get enough information based on evidence and hence be able to educate patients effectively. This implies that patients will be able to take proper care of their health, which, in turn, will lead to improved and effective treatment. Second, such scenarios would make it easier for the doctors to attend such patients and at the same time help to treat them. In addition, studies have shown that using evidence based care tools is effective for reducing care gaps that exist between cardiac clinical nursing (cardiac surgery and acute myocardial infarction) and other forms of specialized nursing. Ought to these tools, a number of improvements have been observed in patient education, physician order tests, depression screening, and rehabilitation/referral techniques. Therefore, as a cardiac clinical nurse specialist, I look forward to attain most of these skills among many others that are closely related to heart treatments.


As a nursing student, I am particularly eager to make sure that I get the most from my studies because I know that this will form the basis of my professional knowhow. That is why, I consider both class work and practical work seriously. A strong foundation is highly critical in determining what happens in the future. Therefore, I consider myself as a person who has a substantial interest in grasping the fundamentals of nursing at both theoretical and practical levels. I consider this feature as being extremely valuable in my career genesis, as nursing is a discipline that requires what Benner et al. call Teche and Phronesis. According to Aristotle, teche can only be attained via scientific knowledge. He insisted that this knowledge should be formal, explicit, and even certain, except for some cases where there is a need to adjust time for a certain class of patients (Benner et al., 2009). This means that as a nurse who intends to specialize in cardiac or heart patients, I will need to have the necessary scientific knowledge, which is acquired from theory. From this explanation, I am also required to learn how to adjust to this particular type of patients. In addition, Aristotle asserted that Phronesis involves practical reasoning, which is cultivated by a continuing experiential learning. This justifies my will to have both practical and theoretical knowledge.

Despite my self-determination, I realize that nursing is a challenging profession because of the iconic and modern standards set by various organizations and the public. Anyone who is already practicing or willing to practice is expected to have the best skills in order to serve better. That is why, doctors and patients focus on the quality of service. In order to meet their expectations, a nurse has to have decent, cordial relationships with doctors and patients. As a nursing student, I have all the needed personal skills that enable me to interact with both patients and doctors. This is possible through the creation of my own personal philosophy, which is aimed at ensuring that the doctors and patients trust me. This will let me communicate with patients effectively and hence improve my skills of educating patients on issues concerning their health. As a student who aspires to become a cardiac clinical nurse specialist, I believe that this knowledge we be helpful for patients since the ailment requires an effective patient education. Similarly, it will be comfortable for the doctors to work with me.

Professional Goals for Advanced Practice as a Clinical Nurse Specialist

It is the desire of any nurse to have a sterling reputation is the field of nursing. This is because nursing as a practice is one of the medical professions that are governed by a set of rules and regulations commonly referred as the code of ethics. For such profession, setting personal goals is crucial, as they are highly effective in leading or guiding behavior towards achieving future career rewards (Rhodes et al., 2011). My main personal goal is to provide a superb care to patients, as this is considered to be the foundational value of nursing. I intend to achieve this through educating patients effectively, giving them hope, and providing physical care. This implies that my major focus will be on supporting patients at all levels.

Proficiency is another important value for nursing. This quality can be achieved through experience in the practical field. I believe that my studying years will allow making a smooth transition from the entry stage to the experienced stage, which is one more professional goal I would like to achieve. This implies that my current experiences are focused on gaining the knowledge that can be used in future. According to Benner et al. (2009) proficiency enables nurses to have the necessary skill to handle a current situation basing on what has been experienced in the past (p.108). This means that experience is the main determinant of whether one becomes proficient or not. In addition, a research conducted to ascertain the relationship between experience and expertise found that initial experience is decidedly pivotal in determining the level of expertise (Bobay et al., 2009). Thus, such experience is responsible for building a personal growth attitude that help one become proficient. The study also revealed that more on-the-job experience is indispensable if a nurse wishes to attain the highest levels of proficiency by any standards. Therefore, I will use these findings in order to attain high professional standards.

Goals after Graduation

I believe that completion of my studies in nursing will pose a formidable challenge about how to start my practice. In this regard, I have set a number of goals after graduation, which is intended to provide guidance for a five-year period. Barnum & Kerfoot (1995) posit that a nurse should be able to give his or her nursing profession a direction by setting goals (p. 51). This helps in shaping a career path as planning should be done based on certain guidelines. Therefore, a personal philosophy is particularly helpful at this stage as it determines how to approach these goals. Therefore, following are my goals that I aim at achieving in five years time.

Develop an understanding of my role as a clinical nurse specialist. My competency for this goal is to be able to demonstrate advanced knowledge and skills while taking care of patients with cardiovascular diagnoses. This is in line with what a nursing specialist in cardiac illnesses is expected to do. Understanding my role will lead to improvement in patients’ treatment, as a professional has to know what is expected of him/her. Another notable aspect of understanding my role is the ability to interact with other medical professionals, which will allow me being  aware of the most current, emergent and relevant issues in clinical nursing. This can be achieved by consulting with colleagues. In addition, this will give me knowledge about the issues that are outside my area of specialty. Therefore, I look forward to being able to remain competent in case a patient will be suffering from cardiac problems and other illnesses simultaneously.

Identify high-risk cardiac patients. My competency will be demonstrated as I will differentiate and apply research studies to identify high-risk patients. Effective skills in identifying ailments with a low degree of severity will enable me to advise patients effective and cost saving medications. Similarly, providing proper treatment schedules for high-risk patients is important for them to get the best services. In addition cardiac illnesses require a specific medication that may be challenging to administer. Therefore, I look forward to offering the best guidance about how the medication can be obtained and used. Identification of high-risk cardiac patients will incorporate knowledge on the latest medicine developments, and that will allow me telling them a lot about pathophysiology. This points to a sub-target, such as providing detailed information about specific cardiac problems, such as cardiac embolism. This helps patients to understand the essence their diseases and hence take proper care of themselves.

Devising appropriate management strategies for cardiac patients. Obviously, organizational abilities are also crucial in the medical field. Therefore, I look forward to demonstrating these abilities through the employment of advanced and collaborative strategies, which I will use when planning care for patients with cardiac alterations. Interactive approaches are hugely beneficial in achieving this goal, since communication is the linking factor. Providing guidelines is also a skill connected to management, as a nurse is expected to single out relevant issues such as symptoms and provide guidelines for drug prescription.

Develop advanced knowledge and clinical expertise in taking care of patients with Acute Coronary Syndrome (ACS). I will demonstrate this competency through practical application of knowledge in employing the correct treatment options tailored specifically to every patients’ needs. Management of Acute Coronary Syndrome requires preceptor advice because they are more experienced than any beginning nurse. ACS requires constant monitoring; therefore, I will make sure that the patient monitoring is effective by either visiting them in their homes or at the hospital. This will allow monitoring critical conditions such as blood pressure increase and other complications that may arise.

Consulting cardiologists and utilizing research in daily operations. I will achieve this goal through a proactive approach, in which I will establish and maintain close relationships with such medical professionals as physicians and other members of the health care team. This will help me to develop my ability to work in a team. Extensive consultations will be crucial, as more ideas can be exchanged this way. This will also aim at attaining the standards set by the Heart Association of America hence to gain the mutual understanding between patients and doctors. Such a symbiotic relationship will contribute to the growth of the profession and successful treatment of heart related illnesses.

To be consistently involved in the in-service for cardiology nursing staff. I will demonstrate this competency with advanced guidance, mentoring relationships, and coaching strategies with the appropriate medical staff. Learning from experienced colleagues is critical in achieving this goal. Therefore, I aim at using preceptors and other professionals to learn about the best in-service techniques that work for cardiac patients. The same approach will help to learn how various heart complications affect patients with biases such as age, and to understand cardiograms better. Interaction is aimed at establishing a better and more accurate diagnosis and prescribing the necessary drugs.

APN Role in Health Care System

Nursing as a profession is highly regulated and monitored. This is made to ensure that the quality of service is acceptable for the set standards. In the United States, this is done at different levels and through different established bodies. There are different non-health related issues, which draw even more attention to the sphere of nursing. For instance, the current economic situation in the country has resulted in various medical care provision strategies that many politicians are reluctant to support. The current Obamacare is one of such policies that, as many argue, will not help American citizens as expected. Therefore, the existing conflict of ideas is likely to affect the quality of care and hence affect nursing as a profession. Since its establishment in the 1950s, the clinical nurse specialists have focused on competencies performed by nurses for better healthcare (Fulton & Lyon, 2009). However, different forces including lack of funding for nurses’ training and poor management skills have frustrated the effort towards this status. Therefore, this has jeopardized the efforts aimed at changing nursing environments to improve care standards. With constant improvement efforts, clinical nurse specialists are likely to overcome the two most difficult hurdles and improve service delivery.

Currently, the role of advanced practitioner of nursing (APN) is regarded as a varying one, depending on the practice settings. Therefore, specialists are expected to work towards realizing the best practices that benefit a specific setting. This will make nursing services qualitative and meeting the abovementioned demands. APN is involved in healthcare promotion programs that include target screening, prevention and counseling, the three critical pillars of comprehensive care (Russell & Hezel, 1994: Hamric et al., 2009). Experts of medicine use these methods to device cost effective strategies and provide better nursing services. With the current economic state, it can be predicted that the role of APNs will become even more significant in the future. This is due to the fact that they have the ability to streamline the bets practitioners and register them as required by their guidelines. Moreover, APNs have been given the mandate or permission to certify certain illnesses that require skilled nursing. Heart problems fall under this category. In fact, this power of APNs gave a push to the enactment of the Omnibus Budget Reconciliation Act, commonly referred To as OBRA in 1989 and 1990, which led to inclusion of the elderly in care programs. Such observations imply that an APN has a significant role in shaping specialized nursing today.

Nursing as a profession is one of the most valuable for humanity. This means that the standards of nursing practices have to be of the highest quality. Therefore, nurses have to understand their area of specialty perfectly and also develop their professional skills. In addition, they should set realistic goals that will guide them up their career ladder, hence benefit the society and themselves. The goals should cover both short and long-term endeavors to enable the nurses to take care of the current and future situations. Finally, nurses willing to specialize in a particular field such as cardiac clinical nursing should make sure that they have a profound knowledge about the socio-economic conditions in their country, in order to organize their work properly. In addition, respective bodies such as advanced practitioners of nursing (APN) should come up with better regulatory mechanisms in order to provide a better service delivery now and in the future.

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