Reflection, a powerful tool necessary for growth and development cannot be overemphasized. It enables an individual identify strengths, areas for improvement and formulate plans accordingly. Self-reflection is a way we regulate ourselves to ensure we keep engaging in a lifelong learning process which is essential to the nursing profession. As an internationally educated nurse, there are similarities, differences between my previous practices and what is expected of nurses in Ontario and there are also some perceived challenges.
Nursing did not start out as a passion for me, I relocated to the United States of America (U.S.A) in 2006 as an Accountant however, I faced some difficulty transitioning and my family advised me to look into nursing as a career, hence the nursing dream was born. I obtained an Associate Degree in nursing at Baltimore City Community College in 2009, took my NCLEX afterwards, and was certified as a Registered Nurse in March 2010. I was privileged to work in the community, in a mental facility, and also in the postpartum unit. I practiced for six years before relocating to Canada in 2016. The College of Nurses of Ontario (CNO) identified some competency gaps to be fulfilled hence my journey at York University. I have often been asked “Why did you not obtain a bachelor’s after your associate degree”? My answer is simple, Life happened. My passion for the profession has grown in leaps and bounds. I count it as a blessing to have the opportunity to nurture another being to optimal health and see trust develop within that relationship. Nursing never stops giving and I am grateful for the opportunity to be able to make a positive difference in the lives of my clients, their families and in the community. A wise friend once told me, “The only limit to greatness is how far you can see”, so I always ask myself, “Where do you see yourself”? My immediate goal is to obtain a bachelor’s degree in nursing by August 2020, next I intend to obtain a degree as a Nurse Practitioner. In five years, I see myself working on getting my doctorate and starting up a practice. To stop dreaming, is to stop growing.
The standard of practice in the USA is similar to that in Ontario however, there are some differences. With an Associate Degree, I was able to practice nursing in Maryland (USA), whereas in Ontario, I read the College of Nurses of Ontario (CNO, 2014) document, and realized that a bachelor’s degree in nursing is required to be eligible to practice. In Maryland, internationally educated nurse (IEN) are eligible to write the NCLEX exam without going to a University whereas in Ontario, an IEN has to go through a “rigorous and challenging process” to achieve the status of a registered nurse (French, 2011 p. 476). An intense and comprehensive education in the university will equip me better in handling challenges in the nursing profession. I previously did not engage in quality assurance programs to demonstrate commitment to continuing competence however, after reading the CNO (2014) document, I realized that I would have to engage in quality assurance programs to continually improve my practice through reflection, setting and achieving learning goals. This will enable me to reflect on my practice, identify and develop a learning plan, and evaluate the effectiveness of my plans thereby maintaining and enhancing my competence. A similarity between my previous practice and the practice standards of the CNO is in the delivery of care. I was taught to deliver optimal care to clients, and to ensure that their well-being and choice are respected, this is consistent with the practice standards of CNO which identifies “client well-being, choice, privacy and confidentiality”, as some of the ethical values in providing nursing care (CNO, 2018). I was also taught to ensure the privacy and dignity of clients during care, for example, pulling the curtains to ensure privacy when performing tasks, this is a similar practice in Ontario as stated in the Code of Conduct to “respect the dignity of clients and treat them as individuals, to take steps to maintain patients’ privacy and dignity in the physical space where they are receiving care” (CNO, 2019). My practice has been to obtain consent before any treatment or service, and from my reading of CNO (2017) document, nurses are accountable for obtaining consent for intervention and services. I had the opportunity to identify, respond appropriately to potential and actual unsafe clinical situations while also sustaining and improving safety practices through continuous education; I read the Canadian Patient Safety Institute (CPSI, 2009) document and I realize that you maintain and enhance patient safety practices through ongoing learning.
From what I read in CPSI (2009), some perceived challenges could be successfully engaging clients in their own care, a learning plan for me would be acquiring knowledge to adequately educate clients thus engaging them more in their plan of care. Another challenge I perceived from reading the CNO (2014) document could be difficulty in articulating and differentiating mandates of regulatory bodies, professional associations and union. A learning plan would be reading the various documents, registering with the organizations and going to membership meetings to familiarize myself with their mandates.
Upon reflection, my experience at the writing center was positive and productive. It was my first opportunity of such. I was guided on how to do an in-text citation, proper referencing format, double spacing and correctly indenting my essays. I was also guided on utilizing online resources.
In conclusion, reflection is an important tool for growth. I had a duty to provide, facilitate, advocate, promote the best care for clients, a duty to share nursing knowledge and expertise with others to meet client’s needs and a duty to ensure practice is consistent with the regulatory body guidelines; these are the foundations I intend to build on to ensure a successful transition into Canadian nursing.