Nursing Continuing Competence Review of Your CRPNBC Articles

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1 Example 12 Annual Continuing Competence Review Your CRPNBC Registration #: A. Self Assessment 1. Have you engaged in a process of self assessment of your practice in the past year? : Yes 2. Registrants are expected to document their annual selfassessment as this becomes the evidence of continued professional development. Please indicate what tools or methods you use to complete your self-assessment.: CRPNBC Continuing Competence Program, CRPNBC Code of Ethics & Standards of Practice, Employer Performance Evaluation, Competency Document Specific to Workplace, Peer Feedback, Self Designed Tool 3. Please indicate how you maintain a record of your self assessment.: Computer File B. Learning Plan 4. Registrants are expected to document their annual learning plan as this becomes the evidence of continued professional development. Please indicate what tools or methods you used to develop your learning plan.: I developed my own tool

2 5. How many Learning Goals did you work on this year?: What learning activities did you utilize as part of your Learning Plan?: Self-directed (journals, books, electronic sources), Activities at work (in-service, peer consultation, on-thejob learning, shadowing) 7a. Please describe any barriers to achieving the goals of your Learning Plan.: The most significant barrier to the achievement of my learning goals this year is time. There never seems to be enough time left in the day or week when one is working full time plus raising a family. This is certainly not new news to anyone reading this or isolated to me, we all with struggle with a short day. However, as a new nurse, juggling all that is required of me is still a work in progress. Working through school which was significant in itself and then blasting onto the stage was eye opening at times. Working 3 casual jobs was difficult and overwhelming, but now that I have gained a permanent full time position I am most certainly finding more time in my schedule. This has allowed me to engage in far more learning opportunities, family time and quality reflection. Fresh out of school time management proved to be the most difficult obstacle I was having in my professional practice and at home due to 3 casual jobs. Being the main income earner in my home it was certainly needed for to accept shifts whenever

3 7b. How did you address these barriers?: possible. I work in a detox centre and at times it can be extremely busy with there only being 1 RPN/RN and 1 detox worker on shift for up to 20 clients. I realized very quickly that the time management skills I developed in school over the past few years were not necessarily going to be effective in the real world. I had to quickly revamp how I structured my shifts, my personal life and work load. This took a little time however, and I found my self going home at the end of the day completely exhausted. I have found over the past few months, however, recognized that my ability to manage my work day has greatly improved and I now feel comfortable that I can have a successful shift each and every day. The exhaustion after a shift is far less, allowing more time for reading and researching. I accomplished this goal through the practice of self reflection. There is simply no better means by which to get organized. Each and every shift needs to be reflected upon and areas of improvement recognized. I have done this through the art of meditation, journal writing, and by requesting critical review from my peers and supervisors. This combination has greatly improved client safety and quality of care when I am on shift as I have more time to spend with clients and in common areas. Having the confidence that I can manage my day appropriately and efficiently gives me peace of mind, reduces

4 C. Continuing Competence Activities my anxiety level and makes me a better nurse and father. In my opinion, self reflection is the most important tool at my disposal in any situation. 8. Registrants are expected to document their continued competence activities as this becomes the evidence of continued professional development. Please indicate what documentation you keep in your professional development file / portfolio / record.: Annual Self Assessment, Certificates, Learning Plan, Letters of Recommendation, Performance Evaluations, Record of Learning Activities, Resume / CV 9a. Please provide at least one The most significant clinical specific example of a new skill, knowledge I have developed this task or knowledge you developed year would be addiction and the over the past year through your role it plays in a persons mental Learning Plan.: health. Being an RPN on a medical detox unit is challenging at times but the knowledge being gained is extraordinary and the information shared between myself and the RN's on the unit has made all of us better nurses. I thought my knowledge of addiction was strong, considering my family history, education level and professional experience on psychiatric units, but I was mistaken. The nature of addiction as it pertains to ones mental health is far more serious than I imagined while I was a student. While I most certainly understand the seriousness of addiction and I recognized the high number of patients with co-occurring disorders on psychiatric units, I

5 was unaware that it is an epidemic. There is no line to be drawn between addiction and mental health they are so overlapped. Some of my peers and classmates questioned my decision to work at a medical detox as I would be out of my psychiatric element, this I have found to be completely misguided, my psychiatric nursing skills are utilized each and every conversation and assessment. Not to mention that about 95% of our clients have been diagnosed with mental health issues. Addiction drives ones mental health and ones mental health often drives addiction and I feel that I am extremely fortunate to be able to gain specific knowledge related to this serious issue as part of my on going learning. There is no shortage of information available on addiction and my place of work, the local health authority, & CRPNBC/CRNBC offer significant learning opportunities in relation to addiction and I have taking advantage of these when I could. Although not as many as I would like to, specifically Core Addiction Practice (CAP) which is a 30 hour course I will be attending in the spring but had wished to attend in July but it was full. Working closely with physicians, psychiatrists and nurses in detox has been a huge source of information for me. Addiction theory is certainly important but being able to sit and chat with

6 doctors who have 30 years of experience in addictions is invaluable. The patient staff at detox are eager to teach and I am eager to soak up knowledge. A new skill I have developed which was focused upon in my learning plan is group therapy facilitation. Working as a student, facilitating group sessions felt much safer due to the presence of a counselor or psychiatric nurse and often times the topic and discussions were pre-arranged. Having to develop, organize and facilitate group sessions without specific guidance was a challenge in the beginning. Lacking confidence due to inexperience I often found myself floundering. Specifically, I was not utilizing Yalom (2011) and the practices I learned in school to properly allow a group to grow, even in more of an acute situation, I learned that I was often rushing. My inability to allow the group to be its own entity was not enabling me to confidently facilitate productive groups. I engaged coworkers from the interdisciplinary teams I work with and through many conversation I have become to better recognize the subtly of group dynamics. Attending other groups led by counselors and psychiatric nurses has also improved my overall group therapy skills. Fortunately, I have positions which allow me to facilitate groups as well as attend sessions led by highly educated workers. I feel far more

7 9b. Please provide at least one specific example of HOW you applied this new learning into your psychiatric nursing practice over the past year. comfortable organizing and directing groups by simply asking lots of questions, reading and observing. Although, there is still much to learn I feel this skill is vital to growth as a psychiatric nurse due to the proven positive effects of group therapy. I have applied my increased knowledge of group therapy each and every set of shifts I work. Regular scheduled group sessions allow me to practice my new skills consistently. For example, last week while working in psychosocial rehabilitaion I recognized observable changes in the willingness of clients to share due to the presence of someone in the group who did not quite fit the dynamic. This person tended to take over the conversation and could be somewhat abrasive. Shortly after graduation I would not have known how to properly defuse the tension in the room with this type of person without offending him or becoming militaristic in my approach. In this situation, however, my improved skills and confidence allowed me to engage this person in a fair manner, discuss the issues without offence by offering my thoughts on how I felt the group 'energy' felt. This conversation allowed the group to grow in confidence due to his recognition that he was being a "negative influence". I discussed this group session with a mentor and was able to determine that I intervened appropiately. The quality of discussion in the groups I

8 facilitate in detox and psychosocial rehabilitation has greatly improved in a short period of time due in large part to my confidence level. I still may be confused or unable to find an answer to a difficult situation in a group session but I have the resources available that allow me to learn and constantly reflect on my practice.