SMART Goals for Clinical Placement

SMART Goals Revision/Reflection

SMART Goals Revision/Reflection

Initial SMART Goal

Goal #1: Theory and skills application that will help in patient care.

S – I will apply all the theories and skills I have learned from our block lab. Specifically, I want to demonstrate a head to toe assessment to my patient as this will serve as a baseline data in monitoring the progress of my patient. The instructor will give me the opportunity to perform different nursing skills that are vital when I go into our first clinical setting by February 2019.

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M – By the time we are getting close into our clinical practice I am going to review all the nursing skills just to make sure that I can safely perform the task given to me like proper transfer technique. I should be competent and efficient especially if I will be conducting a quick prior assessment to our patients’ which includes checking their ABC (airway breathing, circulation), vital signs and pain assessment with the use of pain scale and LOTARP method and pain management.

A – I want to have a good performance review in our clinical practice. I will spend at least 30 minutes of my time to go over my notes like my student journal and practice the skills that I need to improve so that I will be confident in doing it.

R – I have worked in the long-term care facility so I have a background when it comes to helping clients in their activities of daily living such as dressing and bathing. However, I still need to spend 50% of the time to learn the skills that need improvement so that I can continue to enhance my knowledge and skills as I want to be a psychiatric nurse.

T – By the time we go for our first clinical experience in February 2019, I should be proficient and confident to perform all the nursing skills that I learned from our clinical procedure 1 and older adult mental health theory.

Core competency nursing body of knowledge on evidenced-based experience, my goal belongs in this 2.3 criterion as it states, exhibit nursing knowledge: theoretical models of nursing, nursing skills, procedures and interventions (BCCNP, 2014).

Revised SMART goal:

I will apply and demonstrate the theories learned in conducting an extensive head-to toe assessment in the older adult clinical placement by March 2019.

Critical Reflection:

I have not met my goal yet because my clinical placement did not start. Hence, I will further my knowledge through reading and practice. Our activity in our Health Care for Older Adults Clinical Practice course helped me in developing my confidence to interact with seniors and encouraged me to measure my proficiency in conducting a head-to-toe assessment. For the past two weeks, we interviewed a senior for us to exercise our assessment skills, I had the opportunity to demonstrate a comprehensive evaluation of the senior’s functional abilities, performed the quick prior assessment which includes vital signs taking and pain assessment (Potter et al., 2014). I was able to use the Katz Index assessment tool to determine if a senior can carry out their daily activities. This tool was developed on a 3-point scale and support scoring performance abilities to be evaluated as independent, assistive, dependent or incapable of performance (Touhy et al., 2012, p. 213).

In my upcoming clinical practice, I will accomplish more once I am exposed to the clinical setting. I will achieve my goal by March 2019, and I will apply the knowledge I gained about conducting a holistic assessment into clients.

Initial SMART Goal

Goal #2: To be familiar and learn more about patient’s cultural and religious belief that may impact their care plan.

S – We are living in a multicultural country, so it is important for me to be aware of our patient’s cultural and religious beliefs. By February 2019, I will be reading various articles related to cultural diversity and multiculturalism. I will use these resources when applicable to my weekly forums.

M – Before our clinical practice starts, I am already aware of and familiar with the cultural and religious beliefs of the patients with different cultural backgrounds. I should be able to have an idea on dealing with these patients with their cultural beliefs when it comes to touch or eye contact. And religious belief like for example, a patient who is a Jehovah’s witness decline blood transfusion because of their faith and religious practice (Chand et al., 2014).

A – I will spend 1 hour to read relevant articles like the aging process and cultural diversity, this will help me gain knowledge when it comes to different religious and cultural beliefs. I will also check different websites if there are current news or research that will give me the idea to render the best possible care for a patient with certain care preference due to their cultural or religious belief.

R – I have an idea with Asian and Indian cultures but I wanted to deepen my knowledge with other cultural and religious beliefs. I will find a place where they offer free learning session especially in my local community centre such as senior and recreation centres.

T – By February 2019, I should be ready and confident to go for my clinical practice as I already have cultural and religious learning when it comes to dealing with patients and render the best quality of care and prioritize their safety.

Core competency area quality care and client safety, my goal belongs in this 5.3 criterion as it states, incorporates cultural knowledge, security, and sensitivity. Also, under 5.3.2 criterion which states that discover the cultural needs, beliefs, practices, and choices of the patient (BCCNP, 2014).

Revised SMART goal:

 I will further my knowledge and will demonstrate competency in assessing clients’ cultural and religious beliefs that may impact their care plan by February 2019.

Critical Reflection:

 I have achieved my goal because I recently had an experience working with an elderly with a different cultural background as mine. Also, I have read articles about the common cultural and religious beliefs of older adults, and we have tackled it in our Health Care for Older Adults Clinical Practice course. One example of a religious belief is a patient who is a Jehovah’s witness decline blood transfusion because of their faith and spiritual practice (Chand et al., 2014). I will be more aware of this situation as I will be reading the care plan and make sure that I will follow their preferences. Another example is for clients with food preferences according to their cultural beliefs and practices, I have studied and understood a related article entitled, Cultural Aspects of Food Choices in Various Communities for Elders by Bermudez and Tucker (2004). Eating practices are controlled not only by physiological necessity and the availability and selection of food but also by cultural standards, insights and information and access to food, which are frequently driven by physical ability and economic conditions (Bermudez & Tucker, 2004, p. 22). These aspects and a number of others shaped by society and culture, people eat to meet personal and biological needs (Bermudez & Tucker, 2004, p. 22). As per Jones and Darling (1996), for immigrants from various ethnic communities, their traditional cultural food and the protection of their customary methods of handling food are both origins of convenience in a foreign environment and a way of preserving their cultural existence (as cited in Bermudez & Tucker, 2004, p. 22). For all cultural groups, food has several implications: Biological (food bring vital nutrients), health (healthy food boost wellness), religious (some food is cherished) and social (food supports to the preservation of traditions and social structure) (Bermudez & Tucker, 2004, p. 22). I will respect the cultural beliefs and practices of my clients. I have deepened my knowledge about the different cultures by going into local community centres and recreation centres to attend any learning sessions that talk about multiculturalism. I also have read relevant articles related to cultural diversity and multiculturalism and I will use these resources and apply evidence-based practice in my patient care as well as include in my reflective journal.

Initial SMART Goal

Goal #3: Maintain a good trusting relationship with other health care providers in order to have a better outcome for the patients’ treatment care plan.

S – As a future nurse, it is important for us to maintain a good working relationship with other health care team. When our clinical practice starts in February 2019, I will build trust with all the team members that I will be working with, like the recreation and wellness therapists, dietician, director of care to individualized nursing care plan of my future resident’s in the senior’s home.

M – Before the start of my shift I will get the endorsement from the nurses on duty and read the reports from the previous shifts so that I have an idea on what had happened for the last 16 hours.

A – I will allow at least 30 minutes of my time to attend staff meetings and care conferences for patients so that I will know if there are updates in the patients’ care plan and if there are some ideas that I can suggest I can share it and if there are some clarifications that I need to know I can also ask my colleagues.

R – I have been working as a care aide and I used to work with all the nurses and other care teams to have the best possible care plan for the patients. As an aspiring nurse, I need to work closely to all the health care team as we are sharing one goal and that is for the betterment of our patients’.

T – After our clinical practice by April 2019, I will use my experienced in working with all the health care providers and I will ensure to maintain the same attitude for the sake of our patient’s well-being.

Core competency area collaborative practice, my goal belongs in this 3.1 criterion as it states, to build and uphold professional relationships that improve patient care and the continuity of care (BCCNP, 2014). Also, under the criterion 3.1.1 which is to create and retain a relationship between team members with the help of interpersonal communication skills (BCCNP, 2014).

Revised SMART goal:

I will collaboratively work with my clinical instructor, and other care staff to maintain a good trusting relationship in order to have a better outcome for the patient’s treatment care plan by the end of February 2019.

Critical Reflection:

I have not met my goal yet because I am only in my clinical placement for a week. However, by the end of February 2019, I should be able to have a trusting relationship with all the health care providers I will be working with especially my clinical instructor to be able to provide my client with the best care plan.  Before my shift starts, I will make sure to review the collaborative care plan from the nurse on duty and after my shift I will make sure to report all the necessary information I gathered and observed from my client. One vital example to cooperate with the nurse is to update them about the client’s daily status like their intake and output, if they have any complaints, if there are any changes in their actions and if there are any bruises noted or redness. Another example is the importance of collaborating about the client’s behaviour like a client who is verbally and physically aggressive. It is imperative to inform the health care team about the client’s actions to prevent the risk of injury of the staff and as well as the client. I will attend a care conference about the client’s recent behaviour and from then the health care team can come up with a plan on how to control the client’s behaviour. I will reach this goal by the end of February 2019, and I will make sure that I will work closely with all the health care team like the recreation and wellness therapists, dietician, director of care as we are aiming to give the clients a safe and good quality of care.

References

• Bermudez, O. I., & Tucker, K. L. (2004). Cultural aspects of food choices in various communities of elders. Generations, 28(3), 22-27. Retrieved from https://search.proquest.com/docview/212260497?accountid=195685
• British Columbia College of Nursing Professionals. (2014). Registered Psychiatric Nurse Entry-Level Competencies. Retrieved from: https://www.bccnp.ca/becoming_a_nurse/Documents/RPN_entry_level_competencies.pdf
• Chand, N. K., Subramanya, H. B., & Rao, G. V. (2014). Management of patients who refuse blood transfusion. Indian journal of anaesthesia, 58(5), 658-64.
• Potter, P. A., & Perry, A. G. (2014). Canadian Fundamentals of Nursing (J. C. Kerr & M. J. Wood, Eds.). Toronto: Mosby Elsevier.
• Touhy, T., Jegg, K., Boscart, V., McCleary, L. (2012). Ebersole and Hess’ Gerontological Nursing & Healthy Aging. (1st Canadian Edition). Toronto, ON: Elsevier