This document provides a summary of the student's nursing portfolio. It outlines various nursing courses completed, key competencies learned, examples of patient teaching, evidence-based practices incorporated, and personal reflections on clinical experiences. Courses covered geriatrics, pediatrics, maternity care, psychiatric nursing, and more. Competencies included assessments, skills, and the nursing process. Evidence-based practices centered around prevention and optimal patient care. Personal reflections demonstrated growth in clinical reasoning and confidence in nursing skills.

1. DEBBIE BOUGHNER
Kent State University College of Nursing
Professional Portfolio
DBoughner@att.net

2. NURS 20020 Foundations of Assessment
and Communication in Nursing
Competencies
◦ Assess information about the health status of the patient which includes subjective and objective data,
physical assessment, and basic equipment such as a thermometer, sphygmomanometer, stethoscope, pen
light, and pulse oximeter. Techniques used in physical assessment include inspection, palpation, percussion,
and auscultation. Areas studied in physical assessment include vital signs, HEENT, Neurological,
Integumentary, musculoskeletal, respiratory, cardiovascular, abdominal, and head-to-toe.
◦ Calculate medication dosages safely and accurately. This includes solids and liquids in regards to converting
order and supply to the same weight measure. Calculate liquids for injection to the degree of accuracy
required dependent upon the type of syringe used. I can precisely convert metric and household systems of
measurement and interpret drug abbreviations, labels, and packaging.

3. NURS 20020 Foundations of Assessment
and Communication in Nursing
◦ Demonstrate therapeutic communication to communicate with patients and other healthcare professionals
which is fundamental to the nursing process. Demonstrate a thorough understanding of the patient-centered
nursing process which steps include assessing, diagnosing, planning, implementing, and evaluating through
use of conceptual care maps.
◦ Identify appropriate nursing diagnoses (NANDA) and patient goals that are specific, measurable,
achievable, relevant, and timed as part of the nursing process. Identify the role of evidence based practice in
the nursing process resulting in quality patient care, increased patient safety, better patient outcomes, and
improved chances of successful outcomes.
◦ Implement principles of asepsis and application in everyday situations. Writing measurable, realistic, client
centered goals and interventions specific to the patient by using conceptual care plans. Implementing the
interpersonal process in relationships to effectively communicate with patients, identify patients’ personal
needs, identify barriers to communication, and formulate objectives as part of the nursing process.

4. Evidence Based Practice Learned:
◦ Handwashing In lab we learned the importance of good handwashing technique is imperative to preventing hospital
acquired infections. Alcohol rubs are not effective against certain microbes, such as C. difficile; antimicrobial soap and
water should be used in these cases. (Taylor, Lillis, & Lynn, 2015, p.543).
◦ Impaired Skin Integrity It is important to turn and reposition patients every 2 hours to help prevent pressure
ulcers. I learned that pressure ulcers can develop quickly, especially for at risk patients. (Taylor, Lillis, & Lynn, 2015,
p.981).
◦ Dysfunctional Gastrointestinal Motility Paralytic ileus can occur postoperatively, putting the patient at risk for
dysfunctional gastrointestinal motility and infection. Use of a rocking chair postoperatively can help to stimulate the
bowels to prevent paralytic ileus. (K. Myers, EBP and Critical Thinking, 2016)
◦ Impaired Mobility Assisting in range of motion exercises is important in preventing contracture deformities for
patients with impaired mobility. (Doenges, Moorhouse, & Murr, 2014, p.254).
As one of six QSEN nursing competencies, evidence based practice has helped me to
correlate and identify issues for use in clinicals through concept mapping. Evidence
based practice will help me to provide safe, effective, patient-centered care based on
research and clinical expertise. Some of the evidence based practice I have learned
that will help me to provide the best care for my patients are:

5. Personal Reflection:
Foundations of Assessment and Communication in Nursing provided me with a thorough
understanding of the basics of nursing. With a solid foundation gained from learning the core values, standards
and practices of nursing. I will be able to continue to build additional nursing skills and further my ability to
understand and identify abnormal findings in clinical. Learning how to perform general head to toe
assessments, focused assessments, and obtaining vital signs are essential skill sets to expanding my education.
I was surprised to find how well microbes adhere to our hands while learning good handwashing
technique. Preventing hospital acquired infections by using good handwashing technique and asepsis
precautions are examples of evidence based practice that I will always remember in the clinical setting.
Learning the head to toe assessment will help me to identify areas of concern that may need further
investigation during clinicals. I was also amazed at the difference that therapeutic communication has made
with my interactions with others. This skill will help me to better plan and implement patient oriented goals,
and to treat the patient, not the disease.

6. NURS 20030 Foundations of Nursing
Interventions
◦ Competencies: Inserting a straight catheter; bed bath and linen change; flushing a nasogastric tube;
administering PO meds; assisting with ADLs PRN
◦ Patient/Family Teaching: Opportunity to teach patient and family about falls prevention to deter
preventable injuries and complications. Keeping floors clear of clutter, wearing nonskid footwear, and
adequate lighting are some examples of falls prevention.
◦ Evidence Based Practice: Applying SCDs to decrease risk for VTE, as indicated, are used to improve
blood flow velocity and empty vessels by providing artificial muscle-pumping action (Doenges, Moorhouse,
& Murr, 2014, p.113).
◦ Personal Reflection: As a student nurse participating in my first clinical rotation at UH Geauga, I have
gained confidence in my assessments and skills learned in the classroom and lab. Before participating in
clinical, I did not have any hospital experience. I found the adjustment to the clinical setting challenging;
however, with each new skill practiced in clinical, my confidence as a student nurse has grown. Applying new
skills has also reinforced my understanding and increased my knowledge base. I was also able to use
therapeutic communication to better help and understand the patients I cared for.

7. NURS 30035 Nursing in Adults Across the
Lifespan
Competencies Geriatrics: Caring for hearing impaired patients, staging decubitus ulcers, Administering
subcutaneous injections, priming IV tubing, Braden Scale assessment. Acute: Starting an IV, caring for patients
with altered mental status, flushing PICC line according to protocol
Patient/Family Teaching Importance of vaccinations in patients with HIV, DASH diet, importance of
preventing pressure ulcers
Evidence Based Practice Patients at risk for impaired swallowing should be offered solid foods and liquids
at different times. This prevents the client from swallowing food before it is thoroughly chewed. Liquids should be
offered only after client has finished eating solids (Doenges, Moorhouse, & Murr, 2014, p.227).
Personal Reflection During this clinical I learned to care for patients from different backgrounds, ages, and
with diverse medical issues. This clinical really helped me to better understand the physiological processes of
different diseases and disease states. I was able better understand the relationship of lab values, diagnostic studies,
assessment findings and how they are related to the patient’s medical diagnosis.

8. NURS 30020 Healthcare of Children
◦ Competencies Monitoring strict intake & output, pediatric head-to-toe assessment, tube feedings, chlorhexidine baths,
calculating safe medication dosages based on weight including safe ranges, family centered care
◦ Patient/Family Teaching I had the opportunity to teach the importance of a high calorie and high protein diet for a
pediatric patient with leukemia. A high calorie and high protein diet is important in preventing infection and maintaining or
improving energy levels. The diet also helps with wound healing from surgeries and impaired skin integrity.
◦ Evidence Based Practice Hospital policies that allow parents to remain with the child patient or an open visitation
policy helps to alleviate the child patient’s fears related to their hospital stay. I had the opportunity to provide pediatric
patients with developmentally appropriate psychosocial care to decrease anxiety and fear related to hospital staff and
procedures (Bindler, Cowen, & Ball 2014). The 8, 10 & 21 year olds I cared for all required unique psychosocial care.
◦ Personal Reflection During this clinical rotation I was able to witness the difficulties families face when their child is
seriously ill. Many of the pediatric patients had leukemia; despite a high survival rate, the experience for the patient and
their family is difficult and terrifying. I was glad to be able to participate in giving family centered care and seeing the
difference in makes for the patient and family. I learned a lot about safe medication dosages; pediatric dosing is very
different from adult dosing and is easier to make medication mistakes. This clinical was unlike the other clinical rotation so
far, and I am grateful for the experience.

9. NURS 30010 Parent and Newborn Nursing
◦ Competencies: Newborn assessment, postpartum assessment, newborn care such as a baby bath and
diapering, reading fetal heart rate and contraction monitors, pain management and reassessing pain,
breastfeeding basics
◦ Parent/Family Teaching I had the opportunity to teach a new mother how to swaddle her newborn to
help the baby maintain body temperature and to provide feelings of closeness and security. I also taught a
mother about nonpharmacological pain relief such as ice packs and a sitz bath.
◦ Evidence Based Practice Pitocin to prevent postpartum hemorrhage, importance of skin-to-skin to
promote breastfeeding and mother and baby bonding (Davidson, London, & Ladewig, 2016).
◦ Personal Reflection This clinical was very different from previous experiences. Instead of helping sick
patients, I was able to help bring a new life into the world. This experience was also very different by caring
for patients who are happy and excited to be there. I was also able to experience the different cultural needs
of different patients and how this resulted in labors that looked nothing alike. This clinical was a very
rewarding experience overall.

10. NURS 40872 Intro to Evidence
Based Practice
◦ Evidence Based Practice I learned about the effects of osteoporosis caused
by a decrease in estrogen related to menopause. Through the evidence based
practice poster presentation, I learned that hormone replacement therapy is not a
first line treatment for osteoporosis. My group anticipated traditional HRT to be a
preferred treatment. Instead, we discovered that selective estrogen receptor
modulators or SERMs is a safer and effective treatment option. HRT is associated
with an increased risk of stroke, coronary artery disease, and breast cancer.
◦ Personal Reflection This course has helped me to better understand research
and how it is used in evidence based practice. By better understanding evidence
based practice and how it applies to the nursing process, I can provide research-
backed, proven, and effective interventions to my patients as a future nurse. This
class has also helped me to further understand the importance of continuing
research and asking clinical questions throughout my career as a nurse. I have
gained confidence in my ability to critically evaluate research studies; I now
understand the level of evidence and what it means about a study.

11. NURS 40030 Psychiatric Nursing and Mental
Health Nursing
◦ Competencies Gained confidence and experience in therapeutic communication
and a better understanding of transference, countertransference, trust and rapport.
Developed nursing goals that correlated with patient’s personal goals and treatment
plan. Considered the patient’s culture, beliefs, and developmental stage when assessing.
◦ Patient Education Led a group therapy session focused on the importance of self-
esteem and mental health. Patients were taught the benefit of good self-esteem, how to
boost self-esteem, and how to acknowledge their own self-esteem. This exercise was to
help with confidence, respect for self, and decrease negative self-talk.
◦ Evidence Based Practice I learned that the nurse-patient therapeutic relationship
is the basis for all psychiatric nursing care. The focus of the therapeutic relationship is
on the patient’s thoughts, experiences, and feelings. This relationship is necessary for
the nurse to build trust and rapport with the patient. Without this, the nurse would be
unable to identify areas of need to enhance the patient’s growth (Halter, 2018).
◦ Personal Reflection This clinical has given me better insight into psychiatric
disorders and the difficulties patients with mental health issues face. I feel that this
experience will help me to become a more compassionate nurse and better equipped to
take the patient’s perspective. Observing patients’ behaviors was extremely helpful in
learning the signs and symptoms of psychiatric disorders; it made things much clearer
than reading the text. Talking about patient diagnoses and observed behaviors in
clinical greatly improved my understanding.

12. NURS 30070 Health Care Policy
◦ Competencies This course has taught me how to advocate for policy change as a nurse. I now know
how to properly contact my representatives to meet with them to discuss a change in policy. I can identify the
need for a team approach for organizational policy development and its effect on patient safety. I have also
developed a more thorough understanding of nursing research and strengthened my writing using APA.
◦ Personal Reflection I have gained a deeper understanding of the importance of nurse advocacy and how
it relates to politics. I have also learned how Medicare and Medicaid expand access to healthcare for
vulnerable populations; Medicare and Medicaid also affect how hospitals are paid for their services and their
effect on policy. Writing a policy paper on nurse staffing issues furthered my understanding of healthcare
policy, nurse advocacy, and research. I have also learned how hospitals and policies such as the Affordable
Care Act affect the delivery of care and continue to evolve the delivery of care.

13. ◦ Personal Philosophy My personal philosophy is to always act out of compassion. Compassion is what motivates me to
provide optimum care and understanding for the patient. In my first clinical rotation, I had a patient that was A & O x 0. She was
afraid and tearful. More than anything else, she just needed someone to hold her hand and sit with her. I often think of her when
I think about the kind of nurse I want to be. Empathy and compassion is what motivates me as a future nurse.
◦ Personal Reflection I have learned that becoming a professional nurse is a career long developmental process. This course
has taught me that advocacy is not only for the patient, but nurses as well. Recognizing and reporting unsafe practices, impaired
nurses, and other concerns is important for the patient and the nurse. Healthcare policy, ethical dilemmas, and an evolving
workforce will continue to change and improve. As a professional nurse, I will have to adapt and change and continue my
ongoing education in order to remain a competent nurse.
◦ Personal Goals My immediate goal as a professional nurse is to work as a bedside nurse to further develop and enhance my
clinical skills. I will need to reflect on my education as a student nurse, review information, and apply what I have learned to
further develop my critical thinking skills as a nurse. I also plan on joining a nursing organization as part of my 1 year goals.
◦ My five year goal is to develop into a confident nurse through ongoing education and clinical experience. At this point in time, I
hope to be preparing to enroll or already enrolled in a MSN program to become a nurse practitioner. I am unsure as to what type
of NP I will become, but hope that my clinical experience will help guide me with this decision.
NURS 40005 Professional Nursing
Development

14. NURS 40010 Nursing of the Critically Ill
◦ Competencies Oral care for patients on mechanical ventilation, monitoring mechanical ventilation, reading and
interpreting EKGs, monitoring and interpreting central venous pressures, ABG interpretation, assessing
neurological status in critically ill patient.
◦ Patient Teaching Taught patient on mechanical ventilation about oral hygiene to help with feelings of thirst, dry
mouth, and to prevent infection. Patient nodded that he understood and was accepting of the interventions.
◦ Evidence Based Practice Proper protocol for sterile technique to prevent nosocomial infections while on
mechanical ventilation. Hyperoxygenate patient for at least 2 minutes to prevent hypoxia and bradycardia (Morton
& Fontaine, 2018).
◦ Personal Reflection At the beginning of this clinical rotation, I felt very intimidated by the high complexity of
the patients; I did not want to inadvertently cause them harm. Throughout clinical, I gained confidence in assessing,
monitoring, and applying nursing interventions to critically ill patients. I was able to expand my knowledge of
pathophysiology. The experiences and knowledge I acquired in past clinical rotations helped tie-in everything I
learned this semester. I feel that I have gained confidence as a student nurse and this experience will help me as a
future RN.

15. NURS 40020 Community Health Nursing
Competencies
◦ Understand the importance of all levels of prevention
◦ Implement primary prevention teaching
◦ Population data collection and analysis
◦ Program planning
◦ Community teaching
◦ Identify determinants of health through different sources of data in a population
Patient Teaching
I taught about primary and secondary levels of prevention related to sexually
transmitted diseases and infections. Cognitive, affective, and psychomotor teaching
domains were used to teach the importance of prevention and risk reduction. I
encouraged prevention through pamphlets, teaching, and visual aids.

16. NURS 40020 Community Health
Nursing
Evidence Based Practice Community health nurses utilize the evidence
based practice process to evaluate populations and find health disparities and
community needs. They follow the EBP process:
0. Cultivate a spirit of inquiry.
1. Ask a clinical question in PICOT format.
2. Search for and collect the most relevant best evidence.
3. Critically appraise the evidence
4. Integrate best evidence with clinical expertise, pt preferences to make a practice
decision or change
5. Evaluate outcomes of the decision or change based on evidence
6. Disseminate the outcomes of the EBP decision or change (Rector, 2018, p. 87)
Personal Reflection I felt that this course helped me to greatly expand on my
knowledge of what roles a nurse can fulfill within the community. I also learned
about resources available to certain populations that I was not previously aware of,
like the DDC. I also found that there was much that I did not know about organ and
tissue donation until we visited Life Banc. I liked how I was able to further my
knowledge on resources that are relevant to many populations from hospice, urgent
care, and through guest speakers.

17. NURS 40045 Integration of Leadership and
Management in Nursing
◦ Competencies IV insertion and maintenance, medication and fluid administration, straight
catheterization, wet-to-dry dressing change, packed dressing change, enema administration, time
management and priority setting, therapeutic communication, documenting in EHR, communication
with team members, strict I & Os, patient education, NG tube decompression and medication
administration, CIWA monitoring, delegating to assistive personnel, O2 administration, ambulation
◦ Evidence Based Practice During my preceptorship at Cleveland Clinic Medina, there was a big
initiative to increase patient ambulation on 2 South. They held several contests to increase compliance
and motivate staff. Ambulation contributes to shorter hospital stays which means quicker recovery for
the patients and cost savings for the hospital (Halpem, 2017). Ambulating patients also has many other
benefits such as preventing DVTs and PEs, improving gastrointestinal motility, increase muscle tone, and
promote patient independence (Henecke, Hessler, & LaLonde, 2015).

18. NURS 40045 Integration of Leadership and
Management in Nursing
◦ Patient Teaching Practicum provided me many opportunities to provide patient education.
◦ Personal Reflection Practicum has been a very positive experience where I feel that I have begun the transition
from student nurse to professional nurse. I was able to make nursing decisions, plan my day, and prioritize my care
under the guidance of my preceptor while caring for multiple patients. Being able to work independently helped
me to further understand the role of a nurse and the demands of the profession. Caring for patients with different
medical issues and levels of acuity helped me gain confidence with clinical decision making and managing a range
of illnesses. The excellent teamwork on the unit also helped me to better understand how teamwork affects patient
care. Practicum has helped me to realize the areas which I still need to continue to improve upon. Overall, I feel
that this experience has given me the confidence to begin my career as a new graduate nurse.
•Medication
•Diet for patients with COPD
•Importance of ambulating
•Importance of q2h turns
•Importance of GI cleanout before colonoscopy

19. References
Bindler, R. C., Cowen, K. J., & Ball, J. W. (2014). Child health nursing partnering with children and families. Upper Saddle River, NJ: Pearson.
Davidson, M., London M., & Ladewig, P. (2016). Olds’maternal-newborn nursing & women’s health across the lifespan tenth edition. Upper Saddle River, NJ:
Pearson.
Doenges, M. E., Moorhouse, F. M., & Murr, A. C. (2014). Nursing care plans. Philadelphia, PA: F. A. Davis Company.
Grove, S. K., Gray, J. R., & Burns, N. (2015). Understanding nursing research building an evidence-based practice. St. Louis, MO: Elsevier Saunders.
Henecke, L., Hessler, K. L., & LaLonde, T. (2015). Inpatient ambulation. Journal Of Nursing Administration, 45(6), 339-344.doi:10.1097/NNA.0000000000000209
Halpern, W. L. (2017). Early Ambulation Is Crucial for Improving Patient Health: Helping post-op patients move as soon as possible should be a clinical
priority. AJN American Journal Of Nursing, 117(6), 15.
Halter, M. J. (2018). Varcarolis’foundations of psychiatric-mental health nursing. St. Louis: Elsevier.
Morton, P. G., Fontaine D. K. (2018) Critical care nursing a holistic approach. Philadelphia, PA: Wolters Kluwer.
Myers, K. (2016). EBP and Critical Thinking [PowerPoint presentation].
Rector, C. (2018). Community and public health nursing promoting the public’s health 9th edition. Philadelphia, PA: Wolters Kluwer
Taylor, C., Lillis, C., & Lynn, P. (2015). Fundamentals of Nursing 8th Edition. Philadelphia, PA: Wolters Kluwer.