Professional Level

NONPF Leadership Competencies 1 Through 7
 

1. Assumes complex and advanced leadership roles to initiate and guide change

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In my career I have always cared for critical care level patients, and the past eight years have been critical patients across the lifespan.  This level of patient care requires a seasoned clinician capable of making autonomous decisions within the bounds of corporate patient care guidelines.  My graduate education thus far has focused on expanding this career knowledge with advanced pathophysiology, assessment, pharmacology and leadership, further strengthening my ability to assume the complex role of nurse practitioner, leading a team in the primary care arena.

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2. Provides leadership to foster collaboration with multiple stakeholders (e.g., patients, community, integrated health care teams, and policy makers) to improve health care.

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Evidence Of Personal Progress Towards Competency.  Critical care is a highly collaborative environment, with nursing, medicine, and ancillary professions sharing equal space at the table of patient care, with the physicians as the leader oftentimes looking to nursing to tell the story of the patient’s condition prior to addressing the plan of care. I developed an interprofessional collaboration project in 2006 titled “A Natural Bridge to True Collaboration” to help incoming first year medical residents get oriented to the ICU team and environment of care.  This project grew out of a sensed mutual frustration between nursing and the family practice residency doctors over roles and responsibilities of nursing and medicine in the ICU setting.  This project paired a resident with a nurse for a shift where the resident shadowed and learned how the ICU operates and what the nurse’s role and workflow are like.  This helped facilitate an introduction to protocols, order sets, team dynamics, and sparked friendships that improved communication.  This project was submitted and accepted for presentation at AACN’s annual National Teaching Institute as a poster presentation (Zettl et al., 2006).  As the trauma coordinator, I unfortunately saw many examples of “what not to do” when outside physicians who called our facility to transfer a trauma patient were met with rudeness and condescension by some of our trauma surgeons.  This behavior was documented by me and followed up on by our medical director in the peer review process.

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3. Demonstrates leadership that uses critical and reflective thinking. Doctoral prepared nurses think strategically and can organize complex organizational and policy changes (AACN, 2006).

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Evidence Of Personal Progress Towards Competency.  I successfully lead Wyoming Medical Center through verification as a Level II Trauma Center by the American College of Surgeons (ACS) in 2012 as the Trauma Coordinator.  This was a 3-year strategic process of identifying areas of needed improvement throughout the organization to meet the parameters for verification as set forth by the ACS, implementing process-improvement plans and evaluating outcomes to close the loop.  I participated in several root-cause analysis processes on hospital-related morbidity and mortality incidents and organized the trauma physician peer review committee.

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4. Advocates for improved access, quality, and cost-effective health care.

Evidence Of Personal Progress Towards Competency.  At the local level, I co-chaired the Trauma Committee and Trauma Peer Review Committee for four years at Wyoming Medical Center.  I participated in writing several trauma-related policies, including the massive transfusion protocol and Tranexamic Acid protocol. 

At the state level, I chaired the Regional Trauma Advisory Council which performed case review and process improvement between referring and receiving trauma centers.  I served on the Wyoming State Board of Nursing for a 3-year term, including one year as President.  This also included re-writing the Wyoming Nurse Practice Act and submitting it for public comment and approval by the Governor, attending annual meetings and education of the National Council of State Boards of Nursing, and participation in disciplinary hearings on license holders. 

At the national level, I was a scholar of the Nurse in Washington Internship (NIWI) and participated in a week-long training that included meeting with my state’s Congressional delegation on Capitol Hill to discuss health care reform legislation (2010). In 2019 I represented our air ambulance company along with our governmental associates to Wyoming legislative committee meetings regarding proposed legislation that would affect reimbursement for air ambulance charges.  I advocated for nurses by co-founding Wyoming’s first chapter of AACN, and we sponsored CCRN review courses and continuing education for RNs to receive continuing education units. I am a current AACN member and a member of the AANP.

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5. Advances practice through the development and implementation of innovations incorporating principles of change.

Evidence Of Personal Progress Towards Competency.  While I served on the Wyoming State Board of Nursing, we identified a weakness in the statutes regarding discipline of an RN suspected of harming patients.  I worked with the BON and the attorney for the BON to re-write the statute to include a provision for summary suspension of a license when patient safety was in jeopardy.  I then took the proposed changes with me to lunch with a state senator and requested he sponsor the change during the legislative session.  He agreed it was a good piece of lawmaking and introduced the bill on our behalf.  It passed with a wide margin.

6. Communicates practice knowledge effectively both orally and in writing.

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Evidence Of Personal Progress Towards Competency.  As stated previously, I lead continuous quality improvement processes in my role as a trauma coordinator.  This involved meticulous recording of the proceedings of trauma committee and trauma peer review as well as verbal presentation of case reviews monthly.  In my current role we are held to a high standard in documentation of patient care records, and each flight is peer reviewed for completeness and compliance with protocols.  When a high-risk flight occurs, this frequently triggers a debrief and clinicians are expected to verbally defend clinical decisions as well as the documentation.  This is a non-punitive process intended to correct mistakes and improve practice.

My formal DNP project at University of Mary achieved its goal to incorporate evidence-based fertility awareness based methodology curriculum into the Women's Health Curriculum in the University of Mary DNP/FNP program.  This project is the first of its kind, incorporating a curriculum formally only used for medical school students at Georgetown University.  A short synopsis of this presentation is included (HERE-see Compendium presentation attached)

7. Participates in professional organizations and activities that influence advanced practice nursing and/or health outcomes of a population focus (NONPF, 2012).

Evidence Of Personal Progress Towards Competency.  Maintaining currency in practice is a constant but necessary challenge and requires commitment of our time and money.  In my current practice, I maintain certifications in the following specialties: Basic Life Support, Advanced Cardiac Life Support, Pediatric Life Support, Neonatal Resuscitation Program, Transport Nurse Advanced Trauma Care, and Advanced Burn Life Support.  I belong to the American Association of Critical Care Nurses and have maintained my Critical Care Registered Nurse (CCRN) certification since 2004.  I joined the American Association of Nurse Practitioners in 2020.  In 2022 I was successful in attaining my Critical Care Flight RN certification and also became a member of the Emergency Nurses Association.