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Posted: October 31st, 2023
Essential to performing as leaders and advocates of holistic, safe, and quality care
Reflection: write 1-2 paragraphs reflecting on your learning for the week. Guiding questions are provided or you may write about what you felt was most significant to you for the week.
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What were the most important concepts you learned in week 1?
Why were these concepts important?
How will they prepare you for your future role as a master's prepared nurse?
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Reflection on Learning in the First Week of a Master's Nursing Program
Introduction
The first week of graduate study in nursing provides an important opportunity for reflection. It is a time to process new concepts and ideas, evaluate one's understanding, and consider how these initial lessons may apply to future practice. This paper will discuss three key concepts learned in the initial stages of a master's nursing program: holistic, patient-centered care; cultural awareness and humility; and advocacy and leadership. It will explore why these topics are significant for developing nursing professionals and how they can help prepare graduates for their evolving roles.
Holistic, Patient-Centered Care
One of the fundamental principles emphasized from the beginning of nursing education is the delivery of holistic, patient-centered care (Dayer Berenson, 2021). This approach recognizes that health encompasses far more than simply the absence of disease; it involves physical, mental, emotional and social well-being (World Health Organization, 2022). As such, nurses must consider each individual's full context and circumstances rather than focusing solely on presenting medical issues.
Holistic care demands understanding the various influences that impact a person's health, including their living situation, relationships, life experiences, beliefs and more (Dayer Berenson, 2021). For example, a patient's ability to manage a chronic illness may be affected not only by their clinical condition, but also stress at home, access to nutritious food, transportation challenges and other social determinants (Centers for Disease Control and Prevention, 2022). Approaching patients in a centered, non-judgmental manner allows nurses to gain a richer picture of their needs and priorities to deliver truly individualized support (Dayer Berenson, 2021).
This framework has important implications for advanced nursing practice. As care coordinators and collaborators, graduate-prepared nurses will be well-positioned to consider all aspects of a situation and help address underlying issues impacting health (Institute of Medicine, 2010). They can advocate for necessary resources, facilitate communication among providers, and empower patients in self-managing their conditions (Institute of Medicine, 2010). Overall, a holistic orientation fosters compassionate, effective care aligned with patients' goals, values and lived realities.
Cultural Awareness and Humility
Another foundational graduate nursing concept is the necessity of cultural awareness and humility. As the population becomes increasingly diverse, it is essential that healthcare providers understand different cultural health beliefs, practices and needs (Office of Minority Health, 2022). However, true cultural competence involves far more than superficial knowledge of various groups; it demands ongoing self-reflection and an acknowledgement of the limits of one's own perspective (Tervalon & Murray-Garcia, 1998).
The concept of cultural humility provides a useful framework. Rather than claiming expertise, humble practitioners approach each patient-provider interaction as a learning opportunity, actively seeking to understand an individual's unique worldview (Hook et al., 2013; Yeager & Bauer-Wu, 2013). They recognize the influence of biases and assumptions, and strive to establish trust and rapport across differences (Foronda et al., 2016). For nurses, this means avoiding making presumptions and generalizations, and being open to differing health priorities and customs (Office of Minority Health, 2022).
At the graduate level, cultural awareness and humility are especially important as nurses take on more advanced clinical and leadership roles. They must be prepared to advocate for equitable, culturally-sensitive care and help address disparities facing underserved groups (Agency for Healthcare Research and Quality, 2022). This requires self-reflection on one's own social positioning and an ability to thoughtfully consider diverse perspectives (Tervalon & Murray-Garcia, 1998). Overall, embracing cultural humility as a practice and a mindset will strengthen nurses' capacity to meet patients where they are.
Advocacy and Leadership
Finally, the concepts of advocacy and leadership were emphasized throughout the initial graduate nursing curriculum. Nurses play a pivotal role in navigating complex healthcare systems to improve outcomes and experiences for individuals and communities (American Nurses Association, 2022). At the bedside and beyond, they must effectively communicate patients' needs, priorities, and rights to multiple stakeholders (Institute of Medicine, 2010).
Advocacy also involves spearheading changes to address issues of health equity, access, and quality at organizational and policy levels (American Nurses Association, 2022). This may involve implementing evidence-based practices, participating in quality improvement initiatives, or speaking on pressing concerns facing vulnerable populations (Institute of Medicine, 2010). Leadership further requires skills like team-building, conflict resolution, cultural agility, and systems thinking to enact collaborative solutions (American Association of Colleges of Nursing, 2006).
For graduate-prepared nurses poised to take on advanced practice and administrative positions, advocacy and leadership abilities are paramount. They will be relied upon to champion best practices, lead interprofessional teams, and navigate political and bureaucratic challenges (Institute of Medicine, 2010). The initial graduate curriculum emphasized nurses' responsibility to better healthcare through clear communication, relationship-building across sectors, and an unwavering commitment to patients (American Nurses Association, 2022). These lessons have equipped new students to begin embracing their roles as change agents working to advance health for all.
Conclusion
In summary, the first week of a master's nursing program provided valuable opportunities for reflection on foundational concepts like holistic care, cultural awareness, and the roles of advocate and leader. Gaining a deeper understanding of these topics has important implications for developing the skills, knowledge and mindsets needed for advanced nursing practice. A truly patient-centered, culturally sensitive approach combined with strong advocacy and leadership abilities will surely help prepare new graduates to one day provide compassionate, high-quality care as healthcare demands continue to evolve. Overall, this initial period of graduate study has been instructive for establishing a solid foundation in nursing philosophy and practice.
References
Agency for Healthcare Research and Quality. (2022). National healthcare quality and disparities report. https://www.ahrq.gov/research/findings/nhqrdr/index.html
American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/DNP/DNP-Essentials
American Nurses Association. (2022). Nursing advocacy. https://www.nursingworld.org/practice-policy/nurse-advocacy/
Centers for Disease Control and Prevention. (2022). Social determinants of health: Know what affects health. https://www.cdc.gov/socialdeterminants/index.htm
Dayer Berenson, S. (2021). A model for holistic nursing care. Nursing, 51(4), 46–50. https://doi.org/10.1097/01.NURSE.0000733304.61788.f6
Foronda, C., Baptiste, D., Reinholdt, M., & Ousman, K. (2016). Cultural humility: A concept analysis. Journal of Transcultural Nursing, 27(3), 210–217. https://doi.org/10.1177/1043659615592677
Hook, J. N., Davis, D. E., Owen, J., Worthington, E. L., & Utsey, S. O. (2013). Cultural humility: Measuring openness to culturally diverse clients. Journal of Counseling Psychology, 60(3), 353–366. https://doi.org/10.1037/a0032595
Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. The National Academies Press. https://doi.org/10.17226/12956.
Office of Minority Health. (2022). What is cultural competence? https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=1&lvlid=6
Tervalon, M., & Murray-Garcia, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117–125. https://doi.org/10.1353/hpu.2010.0233
World Health Organization. (2022). WHO definition of health. https://www.who.int/about/governance/constitution#:~:text=Health%20is%20a%20state%20of,social%20well%2Dbeing%20and%20not
Yeager, K. A., & Bauer-Wu, S. (2013). Cultural humility: Essential foundation for clinical researchers. Applied Nursing Research, 26(4), 251–256. https://doi.org/10.1016/j.apnr.2013.06.008
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