The essence of this essential is the acquisition of knowledge and skills that are consistent with nursing and healthcare goals to eliminate health disparities and to promote excellence in practice including communication, collaboration, negotiation, delegation and coordination.

     Most recently, my graduate education has helped me be a part of providing quality cost-effective care at my current clinical site which is a nurse-managed clinic:(https://www.etsu.edu/nursing/practice/sites/johnsoncity.aspx). This clinical opportunity has also allowed for my participation in the implementation of care and assumption of a leadership role in the management of human, fiscal, and physical healthcare resources. Journals are provided that document how I met this portion of the essential. 

     This program required a substantial amount of collaboration in the way of group projects. Each group project required me to work with my student colleagues and also people in the community to deliver education to the public. One of my favorite projects was the Geriatric Health Promotion project for which we chose "medication safety" as the topic. There were four members in our group including me and our choice required collaboration with the Senior Center in Kingsport to set up a time for us to present to a group of seniors. Our group created a fun yet educational program that addressed a serious problem for our senior citizens and all of them were very thankful for the information. A second group project that required collaboration and communication was the service learning project for pediatrics. Myself and a student colleague worked with Girls, Inc. to deliver a program/ presentation on healthy eating to a vulnerable population. This project required setting a time with the program director at Girls, Inc. and developing an age appropriate curriculum to deliver the information. Both projects taught me how to collaborate with my peers and with members and organizations  within my community for health promotion. These are essential skills for an APRN. 

     Another example to show my competence in this essential is a soap note in which a referral had to be made to a pediatric endocrinologist after seeing a pediatric patient for precocious puberty. This required us to make the referral and then see the patient back as a follow up after seeing the specialist for a well child visit. This collaboration is something that I will be doing frequently as an APRN and is also an essential skill.  

     Finally, an ultimate example of collaboration and maintaining communication within inter-professional teams was participation in a research group with Donna Frazier. We met a few times during the semester to monitor progress and discuss the research that we had found. Her study was in the beginning stages so we completed annotated bibliographies on research associated with her topic. Included as evidence for meeting this essential is an email log of our meeting. 

     One of my weaknesses in this area was confidence in myself to be able to deliver an educational program in the community and I got the opportunity to do it twice. Another weakness was knowing who to contact in the community for opportunities to teach.

     I consider inter-professional collaboration one of my strengths in this area because I am good at working in groups for a project because I pull my weight and put in my fair share of work. Another strength with collaboration and care coordination comes from my fifteen years experience as an RN and having to communicate with many members of interdisciplinary teams and specialists. I have even had experience dealing with insurance companies for patients. I am very comfortable working in a team.