pop objective part 5 lisa tripp

Running head: PERSONAL OBJECTIVES PLAN: PART 5 1
Personal Objectives Plan: Part 5
Lisa Tripp
California Baptist University
Author’s Note
This paper is presented to Professor Schmidt in partial fulfillment for the requirements of
Capstone Practicum, NURS 546C on July 10, 2016.

PERSONAL OBJECTIVES PLAN: PART 5 2
Personal Objectives Plan (POP) Part 3 and 4
The goal of the Personal Objective Plan part 5 is to reflect on the original goals and plans from
POP part 1 and 2, revised goals from POP part 3 and 4, areas for continued growth, and plans for the
future. Beginning this preceptorship with goal setting was truly a blessing as I was able to create
objectives that were truly attainable and achieve a focus for my experience throughout the semester. I
feel proud and accomplished knowing that I was able to focus my intentions on these goals and achieve
the majority of them by advocating for my own learning and seeking new and meaningful opportunities.
I know that because of my experiences on the Labor and Delivery Unit at SBCH over the past 10 shifts,
my nursing practice as a student has truly changed for the better, and I will continue to employ the skills
I have learned as a registered nurse in the future.
POP Goal #1
Original Goal (POP Part 1 and 2)
It is my goal to perform two vaginal exams by the end of my fourth shift, four vaginal exams by
the end of my sixth shift, and six vaginal exams by the end of my eighth shift in the Labor and Delivery
Unit at San Bernardino Community Hospital according to hospital policy and procedure and to correctly
determine cervical dilation as confirmed by my preceptor. To achieve this goal I will inform my
preceptor of this goal and my anticipated achievement timeline (two vaginal exams by the end of my
fourth shift, four vaginal exams by the end of my sixth shift, and six vaginal exams by the end of my
eighth shift) and ask that my preceptor help to facilitate opportunities to achieve this goal and to confirm
my cervical dilation findings.
Goal Revision (POP Part 3)
A goal evaluation was performed and the following revision was made due to original goal
completion: It is my goal to perform four vaginal exams by the end of my fourth shift, eight vaginal

exams by the end of my sixth shift, and twelve vaginal exams by the end of my eighth shift in the Labor
and Delivery Unit at San Bernardino Community Hospital according to hospital policy and procedure
and to correctly determine cervical dilation as confirmed by my preceptor. To achieve this goal I will
inform my preceptor of this goal and my anticipated achievement timeline (four vaginal exams by the
end of my fourth shift, eight vaginal exams by the end of my sixth shift, and twelve vaginal exams by
the end of my eighth shift) and ask that my preceptor help to facilitate opportunities to achieve this goal
and to confirm my cervical dilation findings. I will continue to evaluate this goal for any changes needed
in the future.
Final Summary of Clinical Skills Achieved
As of my tenth shift, I have been able to perform ten vaginal exams according to my original
goal criteria (one shift one, zero shift two, two shift three, two shift four, two shift five, zero shift six,
zero shift seven, one shift eight, one shift nine, and one shift ten). The vaginal exams that I have
performed have been according to hospital policy and procedure and confirmed sterile and for the most
part accurate (+/- 1 cm dilation, 10% effacement, and 1 station) according to my preceptor.
Reflection on the Goal and Plans for the Future
As of my tenth shift, I have partially completed my revised goal of completing twelve vaginal
exams by my eighth shift. Although revising my goal to complete more vaginal exams seemed realistic
at my fifth shift, the goal ultimately was not achieved in full because of low census and a high number
of scheduled Cesarean Sections (these patients do not require vaginal exams). I can continue to work on
this goal in my practice as a nurse by looking for as many opportunities as possible on the floor to refine
my skills. Additionally, I can consult with my experienced nurse peers at my workplace for tips about
how to accurately determine dilation, effacement, and station in a way that makes the patient feel most
comfortable. I can also let my nursing supervisor know about my goals in order to have help with

facilitation of opportunities.
POP Goal #2
It is my goal to place and interpret two fetal monitors by the end of my fourth shift, four fetal
monitors by the end of my sixth shift, and six fetal monitors by the end of my eighth shift in the Labor
and Delivery Unit at San Bernardino Community Hospital according to hospital policy and procedure
and to achieve appropriate placement and accurate strip interpretation as confirmed by my preceptor. To
achieve this goal I will inform my preceptor of this goal and my anticipated achievement timeline (two
fetal monitors by the end of my fourth shift, four fetal monitors by the end of my sixth shift, and six fetal
monitors by the end of my eighth shift) and ask that I be alerted of any opportunities that exist to achieve
this goal. I will ask my preceptor to supervise me in performing this skill and offer any corrections and
advise available in order to improve.
completion: It is my goal to place and interpret four fetal monitors by the end of my fourth shift, right
fetal monitors by the end of my sixth shift, and twelve fetal monitors by the end of my eighth shift in the
Labor and Delivery Unit at San Bernardino Community Hospital according to hospital policy and
procedure and to achieve appropriate placement and accurate strip interpretation as confirmed by my
preceptor. To achieve this goal I will inform my preceptor of this goal and my anticipated achievement
timeline (four fetal monitors by the end of my fourth shift, eight fetal monitors by the end of my sixth
shift, and twelve fetal monitors by the end of my eighth shift) and ask that I be alerted of any
opportunities that exist to achieve this goal. I will ask my preceptor to supervise me in performing this
skill and offer any corrections and advise available in order to improve. I will continue to evaluate this

goal for any changes needed in the future.
Final Summary of Clinical Skills Achieved (POP Part 4)
As of my tenth shift, I have placed and interpreted fetal monitors and tocodynamomometers on
every patient I have had, totaling twenty, according to my original goal criteria (three shift one, one shift
two, two shift three, two shift four, and two shift five, two shift six, four shift seven, one shift eight, two
shift nine, and one shift ten). The monitors that I have placed and interpreted have been according to
hospital policy and procedure and confirmed accurate and timely according to my preceptor.
I have successfully completed my revised goal of placing twelve sets of monitors for my patients
by my eighth shift. I can continue to improve in this area in my practice by refining my Leopold’s
maneuver techniques in order to determine the location of the baby and attain fetal heart tones faster.
Additionally, I can continue to refine my strip interpretation skills by learning to notice subtle changes
(such as hidden late decelerations) and implement corrective interventions before they threaten my
patients’ safety. I can achieve these goals by consulting with my peers who have had much more
experience placing and reading monitors, and letting my nursing supervisor know about any weaknesses
and needs for further that education that I might have.
POP Goal #3
It is my goal to place two foley catheters by the end of my fourth shift, four foley catheters by
the end of my sixth shift, and six foley catheters by the end of my eighth shift in the Labor and Delivery
Unit at San Bernardino Community Hospital according to hospital policy and procedure as supervised
and determined sterile and successful by my preceptor. To achieve this goal I will inform my preceptor
of this goal and my anticipated achievement timeline (two foley catheters by the end of my fourth shift,

four foley catheters by the end of my sixth shift, and six foley catheters by the end of my eighth shift). I
will ask my preceptor to reserve any anticipated foley placements for me and ask that my preceptor
watch insertion to ensure accuracy and sterility.
No revision to the goal was made. Goal was partially achieved, but not yet completed. At the
midway evaluation (POP part 3 and 4), I believed that future opportunities would arise before the end of
the 10 shifts to care for two more epidural or Cesarean section patients in need of foley catheters in
order to complete this goal, so the original goal was kept.
Summary of Clinical Skills Achieved (POP Part 4)
As of my tenth shift, I have placed six foley catheters according to my original goal criteria (one
shift one, zero shift two, one shift three, one shift four, zero shift five, one shift six, zero shift seven, two
shift eight, zero shift nine, and zero shift 10). The foley catheters that I have placed and have been
inserted according to hospital policy and procedure and confirmed accurately placed and inserted in a
sterile manner according to my preceptor.
I have successfully completed my goal of placing six foley cathethers by the end of my eighth
shift. I can continue to grow in my skills in the future as a nurse by working to carefully maintain sterile
technique. Additionally, I can grow by becoming more consistent at always correctly identifying the
urethra on the first insertion attempt in order to reduce the number of attempts and infection risk. I can
achieve this goal over time by gaining more experience with insertion and becoming more familiar with
the varied anatomy of the population I work with.

POP Goal #4
It is my goal to perform teaching on the labor process, the newborn, and the postpartum period
for one patient per shift in the Labor and Delivery unit at San Bernardino Community Hospital
according to hospital policy and procedure as supervised and determined appropriate by my preceptor.
To achieve this goal I will review labor, newborn, and postpartum teaching materials before each shift
and alert my preceptor of this goal and my anticipated timeline (one patient per shift). I will ask my
preceptor to reserve patient teaching for me to complete and ask that my preceptor observe the teaching
in order to ensure that teaching is thorough, complete, and accurate.
No revision to the goal was made. At the midway evaluation (POP part 3 and 4), the goal was
partially achieved but not yet completed, and I believed that future opportunities would arise before the
end of the 10 shifts to have the opportunity to provide teaching for at least one patient each shift for the
remaining duration of my preceptorship. The original goal was kept.
As of my tenth shift, I have been able to provide teaching under my preceptor’s guidance for
every patient that I have had, totaling twenty, according to my original goal criteria (three shift one, one
shift two, two shift three, two shift four, two shift five, two shift six, four shift seven, two shift eight, one
shift nine, and one shift ten). The teaching that I have provided has been in accordance with hospital
policy and procedure and confirmed appropriate and accurate by my preceptor.
I have successfully completed my goal of providing teaching for at least one patient per shift
over the course of the past ten shifts. I can continue to improve in this area in the future by tailoring my

teaching to each patient’s specific circumstances and histories. I can also work on considering my
patients’ level of health literacy when providing teaching. In order to achieve this goal, I can continue to
brush up on my labor and delivery knowledge, while closely assessing my patients’ levels of
understanding before and after teaching is offered.
POP Goal #5
It is my goal to care for one PIH patient by the end of my fifth shift in the Labor and Delivery
Unit at San Bernardino Community Hospital including assessment of DTRs, assessment of I&O,
implementation of seizure precautions, and administration of magnesium sulfate while monitoring for
toxicity according to hospital policy and procedure and as supervised by my preceptor. To achieve this
goal I will alert my preceptor of the desire to care for a PIH patient, the tasks I wish to accomplish, and
my anticipated goal completion timeline (one PIH patient by the end of my fifth shift). I will ask my
preceptor to alert me to any PIH patients on the floor in order to attain an opportunity to interact with
this patient, provide care, and practice skills. I will ask my preceptor to monitor my care and skill
completion in order to ensure that the appropriate assessments are performed correctly and in a timely
manner.
A goal evaluation was performed and the following revision was made due to lack of goal
progress and the unrealistic/untimely nature of the original goal: It is my goal to care for one PIH patient
by the end of my tenth shift in the Labor and Delivery Unit at San Bernardino Community Hospital
including assessment of DTRs, assessment of I&O, implementation of seizure precautions, and
administration of magnesium sulfate while monitoring for toxicity according to hospital policy and
procedure and as supervised by my preceptor. To achieve this goal I will alert my preceptor of the desire

to care for a PIH patient, the tasks I wish to accomplish, and my anticipated goal completion timeline
(one PIH patient by the end of my tenth shift). I will ask my preceptor to alert me to any PIH patients on
the floor in order to attain an opportunity to interact with this patient, provide care, and practice skills. I
will ask my preceptor to monitor my care and skill completion in order to ensure that the appropriate
assessments are performed correctly and in a timely manner. I will continue to evaluate this goal for any
changes needed in the future.
As of my tenth shift, I have been able to care for one antepartum PIH patient and one post-
partum PIH patient readmitted to the floor two weeks after her delivery for continued symptoms.
I have been able to successfully complete my revised goal of caring for one PIH patient by the
end of my tenth shift. Although this goal was completed, I can continue to learn more about PIH and
how to care for patients affected by it in my future nursing practice. I will certainly have many patients
in the future who are affected by this condition. I can continue to work toward this goal by actively
seeking out learning opportunities, knowledge, and experience from my seasoned peers who work with
PIH patients on a frequent basis. I also plan to find a nurse I can turn to the first couple of times I have
PIH patients in order to confirm that I am providing safe, competent, and comprehensive care.
POP Goal #6
It is my goal to implement induction procedures for one patient by the end of the tenth shift in
the Labor and Delivery Unit at San Bernardino Community Hospital including fetal heart rate and
contraction monitoring, assessment of cervical dilation, titration of Pitocin, and administration of
Cervidil according to hospital policy and procedure and under the supervision of my preceptor. To

achieve this goal I will alert my preceptor of this goal, the desired skills to be performed, and the
anticipated goal achievement timeline (one patient by the end of my tenth shift). I will ask my preceptor
to observe and provide guidance during assessment, treatment regimen implementation, and subsequent
monitoring.
No revision to the goal was made. At the midway evaluation (POP part 3 and 4), the goal was
not yet completed, but still determined to be highly important to achieve, so the goal was not altered. At
the time, I believed that the goal was still realistic and attainable, and I believed that future opportunities
would arise before the end of the 10 shifts to have the opportunity to provide care for an induction
patient by the end of my tenth shift. The original goal was kept.
Although I never had an induction patient during my preceptorship, as of my tenth shift, I have
been able to partially and indirectly meet my goal of caring for an induction patient by administering
and titrating Pitocin for labor augmentation patients for a total of five patients (one shift one, zero shift
two, one shift three, one shift four, zero shift five, one shift six, and one shift seven). The opportunities
that I have had to administer and titrate Pitocin have been in accordance with hospital policy and
procedure and confirmed appropriate and accurate by my preceptor.
I have been able to partially complete my goal of caring for one induction patient by the end of
my tenth shift. Although the opportunity to work with an induction patient never presented itself during
my preceptorship, I was able to work with patients receiving Pitocin, a drug used during induction,
while caring for labor augmentation patients which was very valuable experience. I will continue to
work on achieving this goal in my future nursing practice by seeking the leadership of my peers during

my first time inducing labor in a patient (i.e the insertion of cervidil). I will perform independent
research on ACOG recommendations for induction techniques. Additionally, I will consult the policy
and procedure manual of my unit to gain knowledge about how my facility would specifically like
induction to be done.
POP Goal #7
It is my goal to care for one patient independently by the end of my tenth shift including the
tasks of admission, insertion of IVs and drawing of labs, specimen collection, placement of monitors,
vaginal examinations, medication administration, foley catheter placement, and assistance of the patient
in the labor process with proper documentation in the electronic health record on the Labor and Delivery
Unit at San Bernardino Community Hospital according to hospital policy and procedure and supervised
by my preceptor. To achieve this goal I will inform my preceptor of the goal and the anticipated
completion timeline (by the end of the tenth shift). I will slowly buildup to achieving this goal by
practicing the skills needed to care for a laboring patient independently throughout the ten shifts in order
to comfortably and correctly perform the skills and assessments needed to achieve the goal
independently by the tenth shift. I will ask my preceptor to observe, offer advice, and provide
corrections throughout the semester in order to better prepare myself for the ultimate goal of
independent patient care by week ten.
completion: It is my goal to care for two patients independently by the end of my fifth shift, four patients
by my seventh shift, and six patients by the end of my ninth shift, including the tasks of admission,
insertion of IVs and drawing of labs, specimen collection, placement of monitors, vaginal examinations,

medication administration, foley catheter placement, and assistance of the patient in the labor process
with proper documentation in the electronic health record on the Labor and Delivery Unit at San
Bernardino Community Hospital according to hospital policy and procedure and supervised by my
preceptor. To achieve this goal I will inform my preceptor of the goal and the anticipated completion
timeline (two patients independently by the end of my fifth shift, four patients by my seventh shift, and
six patients by the end of my ninth shift). I will slowly buildup to achieving this goal by practicing the
skills needed to care for a laboring patient independently throughout the ten shifts in order to
comfortably and correctly perform the skills and assessments needed to achieve the goal independently
throughout the preceptorship. I will ask my preceptor to observe, offer advice, and provide corrections
throughout the semester in order to better prepare myself for the ultimate goal of independent patient
care. I will continue to evaluate this goal for any changes needed in the future.
Summary of Clinical Skills Achieved (POP Part 4)
As of my tenth shift, I have been able to provide total care for seven patients independently of
my preceptor according to my original goal criteria (zero shift one, zero shift two, one shift three, zero
shift four, one shift five, one shift six, one shift seven, one shift eight, one shift nine, and one shift ten).
The total and independent care that I have provided independently of my preceptor has been in
accordance with hospital policy and procedure and confirmed appropriate and accurate by my preceptor.
I have been able to successfully complete my goal of caring for six patients independently by the
end of my ninth shift. Although achieving this is a big accomplishment for me, there is much work to be
done in the future. As a Labor and Delivery nurse, I will ultimately have to provide complete care for up
to three patients at a time, so I will need to learn how to juggle tasks and time manage care for multiple
patients. This is something that I will work on in my first nursing job, and I know that the experience

that I have had independently caring for one patient at a time will serve me well.

pop objective part 5 lisa tripp

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