College of NursingMSN ProgramNURS 591L Weekly Clinical P

College of Nursing
MSN Program
NURS 591L Weekly Clinical Practicum Activity
Summary/Reflection Log
Weekly practicum activity summaries and reflections to be
submitted for review are to be typed, grammatically correct, and
error free.
Weekly practicum activity summaries should include:
1. Stated weekly focus and learning objectives.
2. Summary of planned or completed activities.
3. Discussion of technology, evidence-based practice, and other
advanced practice role implementation issues studied during the
week.
4. Reflection on the week’s learnings and implications for your
own nursing practice.
Students will receive feedback from faculty regarding their
weekly personal learning objectives, activities, and reflections.
The purpose of weekly clinical practicum activities and
summaries is to expose the MSN nursing student to advanced
practice roles and their effect on health care.
Template for Weekly Practicum Activity Summary
Directions: Submit a three- to five-page summary of each
week’s activities using the template below. If an interview is
conducted, also attach the list of interview questions used.
Name:
Week #_ Focus:
1. My personal learning objectives this week (list):
a.

b.
c.
2. Summary of planned/completed activities:
3. Discussion of issues identified and studied this week:
Include two or more citations from relevant literature using
APA 6th ed. format.
4. Reflection on your own learning for the week and
implications for your nursing practice:
NURS 591L Weekly Clinical Practicum Activity
Summary/Reflection Log
NR103_Transitions_Paper_Guidelines 1
Transitions Paper Guidelines
Purpose
The purpose of this assignment is to explore a critical concept
in nursing. The student will be able to demonstrate
application of information literacy and ability to utilize
resources (library, writing center, Center for Academic Success
[CAS], APA resources, Turnitin, and others) through literature
search and writing the paper.
Course outcomes: This assignment enables the student to meet
the following course outcomes.
CO 2: Identify characteristics of professional behavior
including emotional intelligence, communication, and conflict
resolution.
CO 3: Demonstrate information literacy and the ability to utilize
resources.

Due date: Your faculty member will inform you when this
assignment is due. The Late Assignment Policy applies to
this assignment.
Total points possible: 150 points
Preparing the assignment
Follow these guidelines when completing this assignment.
Speak with your faculty member if you have questions.
1) Locating Evidence
a. Using the Chamberlain University library, search for a recent
(published within the last five years) evidence-
based article from a scholarly journal that addresses one of the
topics listed.
• Safety
• Delegation
• Prioritization
• Caring
2) Include the following sections.
a. Introduction - 20 points/13%
• Clearly establishes the purpose of the paper
• Includes key points to be covered
• Captures the reader’s interest
b. Body of Paper - 60 points/40%
• Complete, well-developed discussion of key points
• Supports the purpose or main idea of the paper
• Logical development of ideas with clear and accurate
information
• Ideas and statements are supported by three or more examples
from personal and/or professional

experiences
• Provides own perspectives on the topic that is reflective,
insightful, and original
c. Conclusion - 30 points/20%
• Clear and concise
• Summarizes key points discussed in the paper
• Leaves a strong impression, message, or idea on the reader
d. Writing Style - 15 point/10%
e. Correct use of standard English grammar, paragraph, and
sentence structure
f. No spelling or typographical errors
g. Organized around required components
h. Information flows in a logical sequence that is easy for the
reader to follow
i. APA Format, and References - 25 points/17%
• There is correct and appropriate use of margins, spacing, font,
and headers
• Document setup includes title and reference pages in correct
APA format
• Citation of sources included in the body of the paper uses
correct APA format for direct and indirect quotes
• All elements of each reference are included in the correct
order
• All information taken from the source, even if summarized, is
cited and listed on the Reference page

• All sources used are nursing journals published within the last
five years
For writing assistance (APA, formatting, or grammar) visit the
APA Citation and Writing page in the online library.
Please note that your instructor may provide you with additional
assessments in any form to determine that you fully
understand the concepts learned.
https://academicwriter-apa-
org.chamberlainuniversity.idm.oclc.org/
NR103 Transition to the Nursing Profession
Grading Rubric
Criteria are met when the student’s application of knowledge
demonstrates achievement of the outcomes for this assignment.
Assignment Section and
Required Criteria
(Points possible/% of total points available)
Highest Level of
Performance
High Level of

Performance
Satisfactory Level
of Performance
Unsatisfactory
Level of
Performance
Section not
present in paper
Introduction
(20 points/13%)
20 points 19 points 15 points 7 points 0 points
Required criteria
1. Clearly establishes the purpose of the paper
2. Includes key points to be covered
3. Captures the reader’s interest
Includes no fewer
than 3 requirements
for section.
Includes no fewer
than 2 requirements
for section.
Includes no less than
1 requirement for
section.
Present, yet includes

no required criteria.
No requirements for
this section
presented.
Body of Paper - 60 points/40%
(60 points/40%)
Required criteria
1. Complete, well-developed discussion of key
points
2. Supports the purpose or main idea of the paper
3. Logical development of ideas with clear and
accurate information
4. Ideas and statements are supported by three or
more examples from personal and/or
professional experiences
5. Provides own perspectives on the topic that is
reflective, insightful, and original
Includes 5
requirements for
section.
Includes 4
requirements for
section.
Includes 3

requirements for
section.
Includes 1-2
requirements for
section.
No requirements for
this section
presented.
Conclusion
(30 points/20%)
Required criteria
1. Clear and concise
2. Summarizes key points discussed in the paper
3. Leaves a strong impression, message, or idea on
the reader
Includes 3
requirements for
section.
Includes 2
requirements for
section.
Includes 1
requirement for
section.
Section present yet

includes no required
criteria.
No requirements for
this section
presented.
NR103 Transition to the Nursing Profession
Assignment Section and
Required Criteria
(Points possible/% of total points available)
Highest Level of
Performance
High Level of
Performance
Satisfactory Level
of Performance
Unsatisfactory
Level of
Performance

Section not
present in paper
Writing Style
(15 points/10%)
Required criteria
1. Correct use of standard English grammar,
paragraph, and sentence structure
2. No spelling or typographical errors
3. Organized around required components
4. Information flows in a logical sequence that is
easy for the reader to follow
Includes 4
requirements for
section.
Includes 3
requirements for
section.
Includes 2
requirements for
section.
Includes 1
requirement for
section.
No requirements for
this section

presented.
APA Style and Organization
(25 points/10%)
25 points 23 points 19 points 9 Points 0 points
Required criteria
1. There is correct and appropriate use of margins,
spacing, font, and headers.
2. Document setup includes title and reference
pages in correct APA format.
3. Citation of sources included in the body of the
paper uses correct APA format for direct and
indirect quotes.
4. Sources are cited correctly on the Reference
page. All elements of each reference are
included in the correct order.
5. All information taken from the source, even if
summarized, must be cited and listed on the
Reference page.
6. All sources used are nursing journals published
within the last five years.
Includes 6
requirements for
section.
Includes 5
requirements for

section.
Includes 3-4
requirements for
section.
Includes 1-2
requirements for
section.
No requirements for
this section
presented.
Total Points Possible = 150 points
n AONE delegation of 10 nurse leaders and
3 guests had an extraordinary experience in
Peru this fall. Our team was diverse and includ-
ed point-of-care nurses in graduate school, nurse man-
agers, a nurse director, academicians, and nurse executives.
HEALTH CARE IN PERU
On our first day in Peru, we visited the Clinica Anglo
Americana in Lima. We met with Morayma Custudio,
director of nursing at the clinic, Veronica Ramos, subdi-
rector, and Flor Vallejos, head of nurse security (quality
management). This hospital and clinic represent the pri-
vate sector of health care in Peru, 1 of 3 basic constructs

based on insurance coverage. Public hospitals serve the
uninsured, social security hospitals serve those with
worker insurance, and private hospitals called clinicas pro-
vide care to those who are privately insured. The public
sector is open to anyone without insurance, covering
approximately 50% of the population. The uninsured
receive basic health care, which is covered through taxes
paid by citizens of Peru. The social security hospitals and
clinics provide care for any citizen who receives a pay-
check, representing about 40% of the population, but
special hospitals provide care for the police and the mili -
tary. Those with worker insurance have money deducted
from their paychecks to cover health care. Lastly, private
hospitals provide care to approximately 10% of the popu-
lation, including a small segment of workers with private
supplemental insurance.
The Clinica Anglo Americana was one of the first in
Peru to receive Joint Commission International accredi-
tation, and it is on the journey to receive Magnet® desig-
nation. The nurse leaders we met there were very
passionate about their work, using a “patient first” philos-
ophy developed at the Cleveland Clinic and a practice
model based on Jean Watson’s Theory of Human Caring.1
On touring the hospital, we saw a very busy emergency
department (ED). ED staff see approximately 70,000 visits
annually. The hospital itself has only 91 inpatient beds,
including 10 ICU beds and 10 pediatric beds. The ED
wait time can be up to 2 hours in the private hospital, and
waits in public hospitals can be 6 days or longer. It is com-
mon for patients to wait up to 6 months to gain access to
care. Only 3 mental health facilities are in operation and all
located in Lima—so rural residents would have to travel
for this care. Peru also doesn’t have advanced practice reg-

istered nurses, who have proven essential in broadening
access to care in the United States.
The nurses generally work 12-hour shifts, with salaries
in public hospitals ranging from $300 to $500 for 150
hours per month and $750 to $1,000 per month in pri-
vate hospitals for the same hours. However, a limited
number of these jobs exist, so it is hard to gain a full -time
position. Most nurses work 2 full-time jobs to earn a
living wage. And the turnover of nurses can be upwards
of 50% due to the challenges with the workload and
work environment. Leaders at Clinica Anglo Americana
appointed a chief nursing officer (CNO) for the first time
this year, equal to other leaders in the organization. The
use of a CNO is relatively new in Peru; in 2013, Clinica
Santa Isabel, a maternity hospital, was the first organiza-
tion to appoint a CNO. At Clinica Anglo Americana,
leaders are making big strides in the professional practice
of nursing in the private sector, but they are experiencing
challenges. Although the organization has strong leaders
advocating for evidence-based practice in structure and
processes, it did not appear to have a robust formal lead-
ership development program for nurses and nurse leaders.
During the week, we also visited a remote indigenous
rural clinic, the Ollantaytambo Medical Center, serving
the medically underserved. This small clinic had very
limited resources. Staff primarily provide maternal care,
delivering up to 10 babies per month. Elective inductions
and c-sections are not available, and the clinic does not
provide many pharmaceutical interventions. Staff ’s biggest
health concern is post-partum hemorrhage, similar to the
United States. They were also concerned about anemia
due to poor diets.
Reflecting on our visits to health care providers,

delegation member Carol Watson, PhD, RN, discussed a
A
AONE Delegation Learns
Challenges, Successes of
Peruvian Nurse Leaders
Bob Dent, DNP, RN, CENP, FAAN
www.nurseleader.com Nurse Leader 371
372 Nurse Leader December 2018
“doing better with less” philosophy. This is different
than “doing more with less.” In today’s tumultuous
health care environment, we sometimes find a need
to “do better” with the resources we have in meet-
ing the cost, quality, and access issues nurse leaders
face regularly.
We also visited with faculty of the school of nursing
at Universidad Norbert Wiener, a private higher educa-
tion institution in Lima where Patrick Palmieri, DHSc,
MSN, ACNP, FAAN, is the Margaret Jean Watson dis-
tinguished professor and dean for the school. Prior to
returning to academia in 2014, he led a team that devel -
oped the largest vertically integrated private health
system in Peru, called SANNA. The school of nursing is
globalizing and advancing the nursing profession
through its work to earn the first international accredi -
tation in Latin America for a school of nursing with the
Canadian Association of Schools of Nursing. The final
site visit is scheduled for October 2019.

At the school of nursing, we formed a circle with
our delegation and the faculty to have a dialogue
about nursing and nursing education. Many students
attended and joined the conversation. The faculty
consisted of nurses with graduate degrees, many of
them working to complete their doctorate degrees.
During these conversations, we learned the nurse-to-
patient ratio in the medical/surgical environment in
public hospitals is up to 30 patients to 1 nurse (and 5
to 1 in private hospitals). A nurse may have the help
of 1 nursing assistant. In the surgical area, the ratio is
14:1, in critical care units, 2:1. To manage these staff
challenges, the nurses ask families to be at the bedside
to assist with providing basic care for their loved
ones. Faculty added they did not have robust data
collection on patient outcomes, largely monitoring
for adverse outcomes.
Nursing students from Universidad Norbert
Wiener receive training at Lima’s Hospital Nacional
Edgardo Rebagliati Martins, a social security facility.
Established in the 1950s, the hospital has 1,600 beds
and employs more than 1,000 nurses. Prospective
nurses have 2 primary ways to enter the field. A 3-
year, technical nurse degree, similar to the LPN, can
be earned. These nurses can delegate tasks to the nurs-
ing assistants. The other way involves a 5-year nursing
degree, similar to a bachelor’s degree, with a research
thesis. For post-graduate work, nurses can earn a 1.5-
year specialization, a master’s degree, and a doctoral
degree in nursing. The faculty and nursing students
voiced a desire to create stronger relationships and
collaborate with nurse leader colleagues around the
world. They wanted to know the ways in which

AONE and other organizations in the US nursing
community were reaching out to them. We discussed
opportunities to collaborate with AONE on nurse
leader development, using the AONE competencies as
a foundation. Here, too, faculty noted that nurse lead-
ership development was lacking in their environments.
At the end of the discussion, the students were asked,
“Why do you want to become a nurse?” Their
The AONE delegation visited the 91-bed Anglo Americana
Clinica in Lima, Peru, a facility in the process of earni ng
a Magnet designation.
Nurse Leader 373www.nurseleader.com
answers were the same as we often hear from US
nursing students—to take care of patients and improve
health care in the communities they serve.
We met with professional nurses from the Colegio
de Enfermeros del Peru, the Peruvian College of
Nursing, perhaps equivalent to the National Council
of the State Boards of Nursing combined with the
American Nursing Association in the United States.
The organization’s role is to strengthen the profes-
sional practice of nursing, along with a social and legal
responsibility to prioritize the development of com-
petencies of the local nurses and nurse administrators.
Peru has 28 regions, each with an organization similar
to US state boards of nursing, reporting to this central
body. Nine elected members serve on the national
board, which acts to defend nurses against unjustified
hospitals complaints and maintain the ethical standards
for the profession. In Peru, approximately 1.5 nurses

are available for every 1,000 people, whereas the
United States has 11.2 nurses for every 1,000 people
(compared with 0.5 physicians for every 1,000 in Peru
and 1.1 per 1,000 in the United States). Similar to the
United States, 10% of nurses are men. The nurses
explained how last year the Colegio Médico del Perú
(Peruvian College of Medicine) attempted to imple-
ment a national law to prohibit nurses from holding
leadership positions in large public hospitals.
Representatives from the College of Nursing also
noted at the local point of care the physician/nurse
relationship is more collegial than at the national level.
LEARNING ABOUT HEALTH NEEDS
We had the opportunity to visit a primary school in a
rural area with children ages 3 to 6 years. The teachers
are very compassionate and seem to love their work,
with some serving at the school for 25 years. The
students sang to us, played with us, and gave us big
hugs. It was an emotional visit for some in the delega-
tion. Although the students had few resources, they
had great attitudes, big smiles, and even bigger hearts.
When the teaching staff was asked about students’
health care needs, 3 big concerns surfaced: dental care,
parasites, and anemia. Earlier in the week, Palmieri
noted Peru has a national campaign to eliminate ane-
mia, as this is a serious health problem. The first nurse
to become a minister in Peru, Liliana La Rosa, was
appointed this year and is working to eliminate this
major problem.
TAKING IN THE CULTURE
When not gaining insights about health care, we
learned about Peruvian culture and history. For
instance, Palmieri explained that a kiss on the cheek is a

fundamental custom for greeting friends and colleagues,
and it helps support relationships. He learned this les-
son shortly after he arrived in Peru some 10 years ago,
when he was scolded at work for neglecting the cus-
tom. Because relationship management is an important
competency for nurse leaders, our group paid attention!
We had opportunities to enjoy many Peruvian
sites, including the Larco Museum, the Sacred Valley,
Pisac Market, Cusco, and Machu Picchu. On the last
day, we had a private guided tour of the Casa Concha
House, learning about the rise and fall of the Incan
empire with anthropologist Jean-Jacques Decoster,
PhD. Decoster mentioned the Inca’s engineering
techniques were remarkable in adapting to their envi-
ronment. He stated, “Culture is a people’s adaptation
to an environment.” I asked him if this could be relat-
ed to settings where professional nurses practice. He
confirmed that yes, nurses would adapt to the envi-
ronment created. This brought to mind the nurses I
had seen in various environments on our trip, skillful-
ly using resources to provide compassionate care. It
also reminded me of the some nurse workplaces in
the United States. Are we creating positive and
healthy workplace environments?
AONE delegation member Joan Osborne, EdD, MSN,
ARNP, hugs a new friend during a visit to a rural
Peruvian primary school.
374 Nurse Leader December 2018
Reflecting on my experience, here are steps nurses
can take to reach out to their international colleagues,

virtually kissing them on the cheek:
• Disseminate research and evidence-based prac-
tices in venues and publications accessible to our
international colleagues. Consider copresenting
with an international colleague.
• Consider having a sister facility in another coun-
try. Collaborate with nurses there to improve
nursing practices.
• Help to bridge the gap between innovation
(research) and nursing practice with our profes-
sional colleagues globally.
• Create positive and healthy workplace environ-
ments where nurses can adapt, creating a culture
where nurses and their interprofessional
colleagues can “do better with less” to improve
global health.
We had an experience of a lifetime in Peru. This
article and the thousands of pictures taken by the
team cannot express the emotions felt nor depth of
the experiences we had on our weeklong excursion.
The people were welcoming, and the food was deli-
cious. Our experience also showed a hunger from
those we met to continue the conversation beyond
this journey. I hope the discoveries we made in Peru
will inform our work as nurse leaders, making the
best use of resources and striving to make a difference
for patients and each other. NL
Reference
1. Watson Caring Science Institute. Core concepts of Jean

Watson’s
Theory of Human Caring Science. 2010. Available at:
https://www.watsoncaringscience.org/files/PDF/watsons-theory-
of-
human-caring-core-concepts-and-evolution-to-caritas-processes-
handout.pdf. Accessed October 24, 2018.
Bob Dent, DNP, RN, CENP, FAAN, is 2018 president of
the AONE Board of Directors. He is senior vice president,
chief operating and chief nursing officer at Midland
Memorial Hospital in Midland, Texas. He can be reached at
[email protected]
1541-4612/2018/ $ See front matter
Copyright 2018 American Organization of Nurse Executives.
Published by Elsevier Inc.
All rights reserved.
http://dx.doi.org/10.1016/j.mnl.2018.10.006
The AONE delegation took in the scenery of Machu Picchu, a
15th century Inca citadel.
of-human-caring-core-concepts-and-evolution-to-caritas-
processes-handout.pdf
mailto:[email protected]AONE Delegation Learns
Challenges, Successes of
Peruvian Nurse LeadersHEALTH CARE IN PERULEARNING
ABOUT HEALTH NEEDSTAKING IN THE
CULTUREReference

College of NursingMSN ProgramNURS 591L Weekly Clinical P

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