Good Copa Model Assessment Essay Example

Professional advancement occurs with gaining education and experience. An active or conscious approach to advancement entails self-assessment of one’s performance to determine specific areas needing improvement. In this manner, efforts are targeted and likely to bring about the desired outcome. The purpose of this paper is to present an evaluation of my performance in several clinical situations using two tools – the Competency Outcomes and Performance Assessment (COPA) and Benner’s stages of clinical competence.

Reflective Thinking/Learning Assignment

The situation in this learning assignment was a code blue that failed to restore normal sinus rhythm in the patient. I became very emotional afterwards that I never wanted to take part in another code. Self-reflection and talking about the experience with peers helped me overcome countertransference that accounted for my emotional paralysis and inability to perform my role optimally in the situation. Developing emotional competence in a code increased my comfort in participating.

COPA Competencies

Communication Skills. I met this competency with the subskill of oral skills. The subskill was demonstrated through talking and listening to colleagues. It was important to view the situation from different perspectives in order to gain the most insights. By initiating conversations about their code blue experiences and determining the differences and similarities between my experience and theirs was I able to derive meaning.
Critical Thinking Skills. This competency was met with the subskill of data collection which was demonstrated through the integration of pertinent data from multiple sources. In my reflection, I did not rely only on how I perceived the event but also considered those of others who went through similar situations. In this manner, I became objective despite dealing with my personal feelings and discovered what phenomenon it was, i.e. countertransference, as well as what skill I needed to learn, i.e. emotional competence.
Human Caring and Relationship Skills. The subskill relationship-based care helped me meet this competency. I demonstrated the subskill by learning emotional competence which is that the patient’s needs and preferences should be the primary consideration, not the nurse’s (Doas, 2011). Knowing when and how to express negative emotions ensures that patient encounters bring about the best outcomes for the patient.
Management Skills. I met this competency through the subskill accountability and responsibility which I demonstrated by seeking personal and professional improvement. Learning from the experience and responding in better ways in the future is a manifestation of my responsibility to enhance the care I provide.
Leadership Skills. I met this competency through the subskill of creativity and the vision to formulate alternatives. I demonstrated the subskill by actively seeking alternative and better behaviors to how I acted in the situation.
Teaching Skills. I met this competency through the subskill of coaching, mentoring, precepting, or teaching. I demonstrated the subskill by being a good example to others in learning from a negative experience and making sure future responses are more effective. Role modelling is a good teaching strategy and is a major task of a mentor (Metcalfe, 2010).
Knowledge Integration Skills. I met this competency through the subskill of integration of nursing, healthcare, and related disciplines. It was demonstrated when I explored the concepts of countertransference and emotional competence in light of my experience, and these concepts are from the discipline of psychology.

Benner's Stages of Competence

Using Benner’s criteria, I showed the proficiency of a Competent Practitioner. In dealing with the situation, I engaged in conscious and analytic contemplation of the situation that was followed by deliberate planning for future experiences which describes the criteria for this stage. If I had been more adept by considering the impact of my emotions and actions in relation to the overall goal of reviving the patient and supporting the family, I would have demonstrated behaviors consistent with a proficient nurse.

Critical Thinking Assignment

The situation pertains to the critical thinking process and clinical decision-making done to assess and treat a patient. Responding to the situation reflected the employment of inquisitiveness, contextual perspective, and open-mindedness as critical thinking habits. Actively eliciting information, analyzing them as whole and in the context of the patient, and being open to differential diagnosis permitted the provision of appropriate patient care.
COPA Competencies
Communication Skills. I met this competency through the subskill of oral skills demonstrated through interviewing the patient and history taking. Consideration of these data led to the determination of the patient’s risks that helped narrow down the diagnosis.
Critical Thinking Skills. I met this competency through the subskill of decision making and prioritizing. It was demonstrated when I used tools in prioritizing the patient’s needs and made decisions as to how these needs can be best addressed.
Human Caring and Relationship Skills. I met this competency through the subskill of morality, ethics, and legality. The subskill was demonstrated through my compliance with the “rights” of medication administration that is consistent with the ethical principle of non-maleficence. I considered it my moral duty to protect the patient from harm that could arise from my own actions.
Management Skills. I met this competency through the subskill of administration, organization, and coordination. It was demonstrated when I considered the need to coordinate with an outpatient cardiac rehabilitation program to facilitate the patient’s participation following her surgery. I also needed to coordinate with other units, i.e. surgery, for the scheduling of the patient’s surgery.
Leadership Skills. I met this competency through the subskill of collaboration. I worked with other members of the health care team including the physician, cardiologist, and surgeon in developing a comprehensive plan of care for the patient. I also made sure the plan was adhered to as appropriate.
Teaching Skills. I met this competency through the subskill of health promotion, health restoration, or effective self-care. I discussed cardiac rehabilitation with the patient and encouraged her to ask questions and communicate her concerns to ensure she understood the purpose and expected benefits of this intervention.
Knowledge Integration Skills. I met this competency through the subskill of evidence-based practice and patient care. It was demonstrated through my adherence to evidence-based guidelines in the treatment and management of an adult with myocardial infarction.

Benner's Stages of Competence

Using Benner's criteria, I showed the proficiency of a Competent Practitioner. In dealing with the situation, the care plan required considerable, deliberate, and analytic contemplation of the patient problem before a diagnosis and care plan was developed which describes the criteria for this stage. If I had been more intuitive and more spontaneous in recognizing the priority patient needs and arriving at a plan of care, I would have demonstrated behaviors consistent of an Expert Practitioner.

Benner’s Domain of Practice: Teaching/Coaching

In this situation, I encountered a post-stoma surgery patient who was due for education on stoma care. Patient cues alerted me to her emotional state that was contributing to the lack of readiness to learn. I explored the issue with her and coordinated with the ostomy nurse for an individualised education plan addressing her post-surgical concerns.
COPA Competencies
Communication Skills. I met this competency through the subskill of oral skills, specifically talking and listening to an individual. I demonstrated this subskill by initiating a conversation with the patient and showing empathy and concern through active listening. The outcome was knowledge of the patient’s difficulty in coping with the change in body function that facilitated interventions to promote successful coping.
Critical Thinking Skills. I met this competency through the subskill of problem solving. The patient clearly was not ready for learning but patient education was scheduled because she was due for discharge the following day. Other nurses interpreted her behaviors as being difficult. However, consideration of alternative diagnoses led to a more accurate interpretation and recognition of the patient’s need.
Human Caring and Relationship Skills. I met this competency through the subskill of client advocacy. This was demonstrated when I communicated to the ostomy nurse the additional learning needs verbalized by the patient so that these can be addressed thus optimizing the educational activity.
Management Skills. I met this competency through the subskill of administration, organization, and coordination, specifically the latter. This was demonstrated by my coordination for the fulfilment of the patient’s learning needs that were not included in the standard ostomy care education provided by the facility.
Leadership Skills. I met this competency through the subskill of assertiveness. Despite the judgment of other nurses as negative behavior, my intuition that it could be something else led me to reassess the patient and later assert among peers the need to consider psychosocial issues among post-ostomy patients.
Teaching Skills. I met this competency through the subskill of supporting the patient goals for life and wellness. I demonstrated this when I advocated for the inclusion of activity limitations as a topic in the patient’s ostomy care education. The topic was a primary concern as it determined her career and daily activities and thus her life and wellness.
Knowledge Integration Skills. I met this competency through the subskill of evidence-based practice and patient care. I demonstrated this through my assessment of the patient’s learning readiness and learning needs for the creation of an individualised education plan which is supported by evidence (Beebe & Schmitt, 2011).

Benner's Stages of Competence

Based on Benner's criteria, I showed the proficiency of a Proficient Practitioner. In dealing with the situation, my approach was more holistic ensuring an education plan tailored to the patient’s need rather than the standard course which describes the criteria for this stage. In addition, past experiences with post-ostomy patients enabled me to more intuitive about the range of needs including the psychosocial aspect. If I had been more fluid and intuitive despite not having prior experience with this patient population, I would have demonstrated behaviors consistent of an Expert Practitioner.

Benner’s Domain of Practice: Diagnostic/Monitoring

The situation pertains to an elderly patient at risk for dehydration but who refused increases in oral fluid intake because he did not feel thirsty. The newly graduated nurse respected the patient’s refusal and saw it as supporting his autonomy. She had the understanding that the patient would eventually drink when he felt thirsty as thirst was the body’s mechanism for signaling the need for fluid replacement. Discussion on the differences in physiological responses among the elderly and the need to provide education on preventing dehydration led to a different approach with the patient.
COPA Competencies
Communication Skills. I met this competency through the subskill of oral skills, particularly group discussion and interaction. Albeit it was just the two of us, I initiated a constructive discussion with the new nurse about the plan of care for preventing dehydration based on a misconception that needed to be corrected.
Critical Thinking Skills. I met this competency through the subskill of integration of theory within clinical practice. I demonstrated this subskill in helping the new nurse individualize the plan of care to consider the patient’s developmental stage. It led to a more appropriate approach than that employed for younger adults.
Human Caring and Relationship Skills. I met this competency through the subskill of teamwork and collaboration. I demonstrated this subskill by being a mentor and working with the new nurse within a team-based or collaborative relationship to foster learning between the two of us.
Management Skills. I met this competency through the subskill of planning, delegation or supervision of others, especially the latter. Taking the new nurse under my wing and monitoring her performance in order to give constructive feedback demonstrates supervision.
Leadership Skills. I met this competency through the subskill of professional accountability and role behaviors. This subskill was demonstrated in my dedication to mentoring the new nurse with the understanding that what I did would help improve the work environment and patient outcomes. Inadvertently, I was also being a good role model for peers who would also like to become mentors.
Teaching Skills. I met this competency through the subskill of coaching, mentoring, or precepting. It is demonstrated by my role as mentor to a new nurse. Being a mentor means many being many things to the mentee, e.g. teacher, guide, nurturer, coach, counsellor, sounding board, and friend (Koortzen & Oosthuizen, 2010).
Knowledge Integration Skills. I met this competency through the subskill of specialty-focused care that is population-specific and individualized. The subskill was demonstrated in my suggesting an individualized approach to preventing dehydration in an elderly patient in consideration of age-related physiological changes.

Benner's Stages of Competence

Employing Benner's criteria, I showed the proficiency of a Proficient Practitioner. In dealing with the situation, I promoted individualised care consistent with holistic nursing practice which describes the criteria for this stage. However, if I had a total approach to care and given anticipatory guidance to the new nurse regarding fluid intake in older adults, I would have demonstrated behaviors consistent of an Expert Practitioner role.

Benner’s Domain of Practice: The Helping Role

The situation pertained to analgesia in an adult Hispanic patient post-hernia repair. He refused pain relief despite overt physiological signs of pain. I understood the reaction to be culturally determined and employed a culturally congruent strategy to enhance patient knowledge and attitudes towards analgesia. The strategy is called LEARN (Campbell and Edwards, 2012).
COPA Competencies
Communication Skills. I met this competency through the subskill of oral skills, namely talking with and listening to individuals. It was demonstrated when I applied the LEARN strategy that entailed listening to the patient’s views, explaining information the patient needs to understand his situation, acknowledging his preferences, recommending alternatives, and negotiating for the best possible pain management method.
Critical Thinking Skills. I met this competency through the subskill of problem solving demonstrated in analyzing why the patient refuses his pain medications despite the signs of pain and selecting and implementing a culturally-congruent approach to analgesia that is both acceptable to the patient and also achieving the best possible outcomes.
Human Caring and Relationship Skills. I met this competency through the subskill of cultural respect demonstrated in recognizing that the Hispanic culture among males has an effect on their utilization of pain medications thus warranting a culturally sensitive approach.
Management Skills. I met this competency through the subskill of human and material resource utilization. I demonstrated this subskill by optimizing clinical support materials made available after the last in-service on transcultural nursing care to address the patient’s pain in an acceptable manner.
Leadership Skills. I met this competency through the subskill of planning, anticipating, and supporting with evidence, specifically the latter. My use of evidence from the clinical support database to back my approach to promoting pain relief in the patient demonstrates my fulfilment of the aforementioned subskill.
Teaching Skills. I met this competency through the subskill of targeting individuals for education. Using the LEARN tool, I was able to explain post-surgical pain, its complications and how it is managed. I was able to present alternatives and negotiate with the patients regarding the best practice.
Knowledge Integration Skills. I met this competency through the subskill of evidence-based practice and patient care. The LEARN strategy has been shown to be effective in negotiating optimum pain relief in light of the patient’s level of understanding, values, and preferences thus making it an evidence-based practice.

Benner's Stages of Competence

Employing Benner’s criteria, I showed the proficiency of a Competent Practitioner. In dealing with the situation, I needed to access the literature in order to come up with an effective plan which describes the criteria for this stage. If I had automatically recognized how the patient’s culture can impact his care and proactively discussed acceptable pain relief methods prior to surgery, I would have demonstrated behaviors consistent of an Expert Practitioner.

Conclusion

The Competency Outcomes and Performance Assessment (COPA) and Benner’s stages of clinical competence permit the assessment of one’s performance in core practice competencies. The tools are useful in monitoring one’s progress that motivates the desire for further professional development. I found out that I am competent in certain areas of performance and proficient in others. These represent my present strengths and weaknesses and will guide my future efforts of enhancing performance.

References

Beebe, C.A., & Schmitt, S. (2011). Engaging patients in education for self-management in an accountable care environment. Clinical Diabetes, 29(3), 123-126. doi:10.2337/diaclin.29.3.123.
Campbell, C.M., & Edwards, R.R. (2012). Ethnic differences in pain and pain management. Pain Management, 2(3), 219-230. doi: 10.2217/PMT.12.7.
Doas, M.D. (2011). Emotional competence makes a difference (for staff and patients)! Journal of Christian Nursing, 28(1), 34-37. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21294463
Koortzen, P., & Oosthuizen, R.M. (2010). A competence executive coaching model. South Africa Journal of Industrial Psychology, 36(1), 1-11. Retrieved from http://www.sajip.co.za/index.php/sajip/article/viewFile/837/897
Metcalfe, S.E. (2010). Educational innovation: Collaborative mentoring for future nursing leaders. Creative Nursing, 16(4), 167-170. doi: 10.1891/1078-4535.16.4.167.