The Professional Nursing Role at a Twenty-Five-Bed Critical Access Hospital: What Baccalaureate Education Adds and Where I Am Going
[Student Name]
University of Phoenix
NSG/397: Professional Nursing Role
Week 5 Assignment
[Instructor Name]
[Date]
The nurse and hospital are a composite written for a model paper.
At our 25-bed critical access hospital in a county of 11,000 people, a registered nurse on nights may cover the emergency department, admit a patient to the medical floor, recover a patient from endoscopy and help stabilize a trauma patient for transfer, all in one shift. I have worked there for seven years with an associate degree. In a small rural hospital there is no specialist down the hall, so the professional nurse is not one role among many; for hours at a time, she is most of the clinical judgment in the building. This paper examines the professional nursing role in that setting, what baccalaureate education adds and my plan for the next five years.
The Professional Role in a Rural Hospital
The professional nursing role combines direct care with judgment, advocacy, coordination and leadership. In this course, I have examined each part: an identity grounded in the profession's values, a scope defined by law and the decision-making framework, standards that govern practice regardless of setting and delegation that extends care without transferring accountability. In a critical access hospital, each part is stretched. The nurse must recognize deterioration across ages and conditions, often with a physician or advanced practice provider available by phone rather than on site; coordinate transfers to distant tertiary centers; delegate to a small number of assistants; and advocate for patients who may be far from specialty care.
What the Evidence Says About Baccalaureate Education
Large studies link baccalaureate education with better outcomes. In a study of surgical patients across hundreds of hospitals in Europe, Aiken et al. (2014) reported that every 10% rise in the proportion of bachelor's-educated nurses went with about 7% lower odds that a patient would die in the hospital after a common operation, alongside the effect of lighter patient loads. In the United States, Blegen et al. (2013) found that hospitals with higher proportions of baccalaureate-prepared nurses had lower rates of congestive heart failure mortality, failure to rescue, hospital-acquired pressure ulcers and postoperative deep vein thrombosis and shorter lengths of stay.
The studies are observational, and wealthier or academic hospitals tend to hire more graduates of four-year programs, so some of the gap may come from the hospitals rather than the degrees. Still, the consistent direction of the findings supports the national goal of increasing the proportion of baccalaureate-prepared nurses, and the National Academies' report on the future of nursing through 2030 calls for strengthening nursing education to prepare nurses for population health, health equity and complex care (National Academies of Sciences, Engineering, and Medicine [NASEM], 2021).
What the Competencies Say Baccalaureate Nurses Should Do
The American Association of Colleges of Nursing's essentials organize professional nursing education into ten competency domains, among them knowledge for nursing practice, person-centered care, population health, scholarship for nursing practice, quality and safety, interprofessional partnerships, systems-based practice, informatics, professionalism and personal, professional and leadership development (American Association of Colleges of Nursing [AACN], 2021). Measured against these domains, my associate-degree preparation and seven years of experience are strong in person-centered care, quality and safety and interprofessional partnerships. They are weaker in population health, scholarship and informatics, and my leadership has been informal.
These gaps matter in my setting. Our county has high rates of diabetes, heart disease and opioid use disorder, and our hospital's quality data are reported to state and federal programs that affect its survival. A nurse who can read research, use data and think at the population level can help the hospital respond to its community's needs.
The Role I Intend to Grow Into
My goal is to become the hospital's nurse educator and quality coordinator, a combined role common in small hospitals, within five years, and to remain a bedside nurse part-time. The role requires the domains I have identified as weak: scholarship to bring evidence into policies, informatics and quality skills to use data and population health knowledge to connect hospital care with the community.
A Five-Year Plan
Year 1: Complete the BSN, choosing an evidence-based practice project on sepsis recognition in our emergency department, where transfer delays make early recognition critical. Measure: project completed and presented to the medical staff.
Year 2: Join the hospital's quality committee as the nursing representative and complete a quality improvement certificate. Measure: lead one improvement cycle on a reported measure.
Year 3: Earn certification in emergency nursing and begin precepting new nurses. Measure: certification earned; two new nurses precepted.
Years 4 and 5: Begin a master's program in nursing education or quality, and assume the educator and quality coordinator role. Measure: role assumed, with a professional development plan for the nursing staff in place.
Barriers and Supports
The plan faces real barriers. Cost is the first: tuition competes with a family budget, although the hospital offers partial tuition reimbursement in exchange for a two-year work commitment, which I have accepted. Time is the second: night shifts, two children and a 40-minute drive leave limited hours, which is why an online program with five-week courses fits better than a campus program two hours away. Distance from mentors is the third, since no nurse at my hospital holds a master's degree in education or quality. To address this, I have asked the director of nursing at the regional referral hospital, who led a similar role at a small hospital, to meet with me by video each quarter, and I will join the state rural nurse organization to find peers in similar roles. Finally, the hospital's own finances are uncertain, and the combined role I hope to hold depends on the hospital deciding to fund it; I will make the case for it with data from the quality work in years two and three, so that the role is justified by results rather than requested as a favor.
Conclusion
In a rural critical access hospital, the professional nursing role carries broad clinical judgment, advocacy, coordination and leadership with limited support nearby. The evidence associates baccalaureate education with better patient outcomes, and the national competencies define what that education should add: scholarship, population health, informatics and formal leadership. Measured against those competencies, my experience is strong at the bedside and thinner beyond it. The baccalaureate degree is the first step in a five-year plan to bring those competencies to a hospital and a community that depend on its nurses.
References
Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R., Diomidous, M., Kinnunen, J., Kozka, M., Lesaffre, E., McHugh, M. D., Moreno-Casbas, M. T., Rafferty, A. M., Schwendimann, R., Scott, P. A., Tishelman, C., van Achterberg, T., & Sermeus, W. (2014). Nurse staffing and education and hospital mortality in nine European countries: A retrospective observational study. The Lancet, 383(9931), 1824-1830. https://doi.org/10.1016/S0140-6736(13)62631-8
American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. https://www.aacnnursing.org/essentials
Blegen, M. A., Goode, C. J., Park, S. H., Vaughn, T., & Spetz, J. (2013). Baccalaureate education in nursing and patient outcomes. Journal of Nursing Administration, 43(2), 89-94. https://doi.org/10.1097/NNA.0b013e31827f2028
National Academies of Sciences, Engineering, and Medicine. (2021). The future of nursing 2020-2030: Charting a path to achieve health equity. National Academies Press. https://doi.org/10.17226/25982
How this NSG 397 Week 5 example is structured
The NSG/397 shelf page describes the closing week as carrying the larger role paper and a forward look at BSN practice. The paper defines the professional role in the setting where the writer practices, then examines what the evidence says baccalaureate education adds, uses the national competency framework to name the gaps it should close and ends with a dated plan. Pulling the course's earlier themes, identity, scope, standards and delegation, into one role statement is what a closing role paper is for. Students search this week as NSG 397 Week 5, NSG397 Wk 5 or NSG/397 Wk 5; all three are the same assignment.
NSG/397 Week 5 questions, answered
What does NSG/397 Week 5 usually ask for?
The course shelf describes the closing week as carrying the larger role paper and a forward look at BSN practice. Many sections ask for a paper that defines the professional nursing role, draws on the course's themes and evidence and describes the writer's goals for baccalaureate practice. Check your rubric for required elements.
Does a BSN improve patient outcomes?
Several large observational studies have found that hospitals with a higher proportion of baccalaureate-prepared nurses have lower patient mortality and better outcomes, even after accounting for other factors. The studies show association, not proof of cause, but they have shaped national goals for nursing education.
How specific should the forward plan be?
Specific enough to check. Name the role, the steps, the dates and the evidence you will use to know you are on track, rather than general intentions to grow professionally.
Write yours, or have the desk draft it
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