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Cover letter
Name
Email Address,
Telephone
City, Country
To:
Hiring Manger’s Name
Nurse Unit Manager
Strathmore Hospital
Alberta, Canada
Date
Dear [Hiring Manager’s Name],
With my proven nursing skills and experience in health care delivery, I am delighted to be submitting
my submission for the position of Local Nurse Practitioner. I am confident that the background and
skills gained make me an excellent fit for the role of Licensed registered nurse practitioner. I have
completed successfully nursing education program and eligible for registration and practice permit
with the College of Licensed Practical Nurses of Alberta (CLPNA). I will collaborate effectively with
the health care team to ensure quality care services to the patients.
I have gained in nursing professionalism where am always within the scope of practice per the
relevant legislation affecting healthcare. I have also gained in provision and coordination of care
where I can respond effectively to unexpected clinical situations as well as accepting accountability
for own actions. I have been able to gain experience in caring for elderly patients and dementia care
for the elderly.
Further, the need for adhering t stipulated guidelines as stated and defined by CLPNA and adhering
to values by AHS will be fundamental in the care process and ensuring high care quality for patients
in the acute and emergency settings.
By being assertive, I will of a beneficial asset to the organization. I am ready to engage with any
commitments about this noble call whenever requested.
Thank you for considering my application.
Yours Sincerely,
First Name Last Name
Licensed Nurse Practitioner:

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Nursing theory reflection
As a future practicing nurse, nursing reflection is essential in the health care environment. It
offers an avenue of self-assessment and reflections to aid improve key fundamental aspects of
patients’ care and service quality. In this review, an assessment based on Watson's nursing theory
on caring for patients is being reflected. Having an opportunity to serve as a local nurse practitioner
at Strathmore health care services will offer an opportunity to demonstrated aspects of care as
outlined by Watson's theory. Caring in the nursing practice is a critical competency that entails
caring for and cares about clients in the care setting, as a fundamental avenue of embedding care
into patients’ process is to incorporate Watson's theory of caring as a key guide for nursing practice.
For nurses to perform caring aspects, there is a need for incorporating scientific and artistic
knowledge into practice. Nursing education is key in the overall advancement and acquisition of care
attributes and needs to adhere to the general nursing ad professional practice (Labrague et al.,
2015).
In my previous practicum engagement, aspects of care were demonstrated in the care service
managing elderly care at an old age facility. The key behavior of nurses in demonstrating caring
aspects can signify a dimension of satisfaction and overall patients well being and critical in the
overall performance of health care organizations (Kaur, Sambasivan & Kumar, 2013). Infusing family-
centered care in this process was a fundamental avenue for providing health and bearing in mind
great recognition of family in the care process. Family-centered care aspects are geared towards
maintaining and offering strength to family roles and enhancing natural bond and promotion of
healthy family functioning (Festini, 2014).
Family-centered care is a critical approach that shapes the overall health care day to day
interactions between the patients, family and other health care allied staff. Health care practitioners,
especially as a nurse in this context, practicing family-centered care, are critical in the overall role of
promoting the well being of the patients and the families at large. Nurses recognize that social,
emotional and development support are fundamental aspects of care delivery in the organization.
Caring practices by nurses can contribute to satisfaction and the overall well being of the
patients and improve the performance of the organization. Based on Watson's theory, caring is
essential for nurses as it entails the end being enhancement, protection, and human dignity
preservation. Hence as a nurse in Strathmore organization, upholding this aspect is essential in
facilitating a family-centered approach of care thus improving the quality of care (Pajnkihar, Štiglic
& Vrbnjak, 2017).
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Furthermore in my essential reflection during the last clinical rotation in a different incident, I
engaged myself in offering total care for an elderly patient who was not eating and drinking
effectively and partial deafness. During this period we engaged with other nurses collaboratively
through providing care, pain control administration, proper elimination through the usage of
catheter and hydration process, the patient improved significantly.
These aspects demonstrated a key component in the nursing profession entailing
collaboration partnerships for care delivery. Health care teams ought to function in unison to offer a
wide range of services to the patients. The need for collaboration amongst the nurses is essential in
the nursing field. Broader engagement on patient issues offers an opportunity for getting varied
views on the patient care process. As a nurse in the organization, I will strive to work together with
other nurses and health care teams. In my previous session, collaboration avenues were entrenched
and incorporated into the care process. This avenue signified an increased state of patient quality
and understanding of the patients more. Thus as a nurse entrenching this reflection to the Alberta
Health services is crucial in delivering care to all patients and working in unison with the rest of the
team members in the care delivery unit.
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Interview questions
Workplace stress has been considered as an occupational hazard. Despite an increased sate of
awareness, nurses continue to face and experience elevated levels of stress. Nurses can experience
stress in four avenues; during patient care, decision-making stage, taking responsibility and change.
Based on the American Holistic nurse association, nurses often encounter workplace stress in a
higher proportion compared to other professions. This stress entails physical demands of the job,
issues related to management, limited resources and having difficulty in balancing work and home
activities (American Holistic Nurses Association, 2015).
In being honest, nurses often experience stress during the caregiving process which is often
emotional and draining. Coupled with interpersonal relationships at work and be a recipe for the
development of stress. Another tragic incident such as communicating with dying persons at the
care facility often can present emotional challenges to nurse. Other aspects such as the societal
increased rate of violent and aggressive patients also lead to increased rates of stress to nurses. Thus
is inevitable for nurses to balance work and home life commitments, a combination of job stress and
everyday worries such as child care, financial issues and aiming for quality life often makes it
challenging (Lu, Zhao & While,2019).
At times nurses have a feeling of not feeling empowered when critical decisions are being
made. They develop a feeling of having their expertise being compromised through poor leadership
aspects and confusion in general. Nurse units often are short staff, leading to little or no time to
engage in the jobs well, leading to poor provision of care and services. Further aspects of budget
constraints often necessitate nurses to work with limited resources with an increased emphasis on
billing expenses and following of regulations can lead to aspects of stress (Dagget, Molla &
Belachew, 2016).
The fundamental role of the employer, in this case, is to nature movements that promote
nurses' empowerment. This is essential in preparing the nurses to cope with stressful states as they
develop. The American Holistic Association of nurses has provided fundamental key solutions to
employers to enable a ground for stress management reduction among nurses (American Holistic
Nurses Association, 2015). Some of the activities being promoted and applicable to me entail
developing stress management programs for staff, regular staff meetings, offering flexible
arrangements in the work, proviso of regular service programs so as the nurses stay updated o
changes in the health care organization and ensuring that there is adequate staff available.

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As a nurse employing self-management strategies is essential. There is a need for focusing on
tasks at hand which often make undoable situations to be doable and breaking tasks into
manageable units. There is also a need to create time always of having natural exposure to the
environment. Studies have demonstrated that exposure to the natural environment can reduce
blood pressure, facilitate connection and feelings and relieve stress. Thus I will entrench these
techniques to facilitate how offer care services to the patients hence enhancing the increased quality
and patient satisfaction.
Challenges in providing care
Despite the increasing rise in problems with patient safety, there are significant gaps in care
and evidence of what type of care should be received and efforts to improve health care quality. As a
nurse, some of the underlying challenges in care delivery entail having the ability to convince other
health care staff that there is a problem. This is a fundamental and often poorly met expectation in
care. A key challenge is convincing other health care workers that there is a current problem that
needs to be addressed. Clinicians can often argue that problems going through targeted intervention
are often not a problem, but there exist other far more problems existing. There is a need for
engaging with the stakeholders through a multidisciplinary approach avenue in designing
intervention which targets real problems of the patients. This is facilitated through the application of
hard data which demonstrated the existence of patient stories that are geared towards engagement
and defining what are likely aspects to improve care service (Dixon-Woods, McNicol, Martin, 2012).
Another fundamental challenge as a nurse is often convincing the other staff that the solution
chosen is appropriate for the given situation. At times interventions can be contested, more often
everyone will agree on good quality but not specific details on what good quality is. Other health
care staff can often resist the premise that the interventions being implemented lack adequate
evidence or being incongruent with preferred ways that exist. There is a need for ensuring that there
is well supporting evidenced on the interventions which are fundamental to patient care and
ensuring that health care staff are briefed and able to handle any challenge which might arise.
Engaging in well-facilitated forums with the entire care team member is fundamental in the care
process (Dixon-Woods, McNicol, Martin, 2012).
There is a need for management of enthusiasm and ambitions in the care delivery. Great
ambitious stretch goals and transformations often risk alienating persons leading to disillusioned if
the aims are not well realized. More often the resources can be underestimated at times, without
adequate financial support, resources, skills, adequate time efforts and strategies to improve care
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quality can be challenging. There is a need for deep discussions on the scale of demand on
intervention improvement and thus careful; assessment is essential from the onset among the key
stakeholders (Dixon-Woods et al., 2011).
The existence of an organization culture's capacities and different contexts can lead to
impairment of care quality to clients. In an instance where the capacity of the organization is limited
and inadequate can lead to emotional exhaustion and lack of support. Further, leadership and
management references in the health care organization can have a negative impact on overall care
quality. Support measures to personal improvement t efforts often are key in leading to improved
efforts, complex care interventions which encounter limited resources and support can have an
impact on the overall care quality of the patients. Limited resources to support the health care
practitioners especially the nurses often can lead to a blow in the care delivery process (Ling et al.,
2010).
Medication errors in the care process
Medication errors are often at the heart and at most responsibility of nurses in avenues of
doing good and harm to the patient. Medication errors have a direct link on systems of care; direct
impact is harming the patient and elevating healthcare-related costs, while indirect results lead to
harm nurse’s professional and personal confidence and practice state. Every person in the health
care is concerned with patient safety; medication errors have a greater impact on the organization
and nurses. Medication errors often occur in various stages that are ineligible writing, dispensing
avenues, calculation errors, monitoring aspects and administration errors (Wahr & Merry, 2017).
Medication errors have the ability o impact negatively the work and duties of nurses. The
inherent trauma of causing medication errors is often immense to the nurse; they often feel upset,
terrified and guilty in thinking about the medication errors.
Nurses play a fundamental role in medication administration across settings, they can
facilitate avenues of dispensing and medication preparation such as crushing of the drugs and
measuring the required volumes for the patients. The fundamental role of a responsible nurse in
encountering this situation of committing medication errors is to be proactive and offer the
necessary steps to prevent this occurrence. The impact of mediation error is immense to both the
patients through increased costs and increased risks of complications to stress among nurses who
often feel dejected and traumatized for the event (Choi et al., 2016).
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As a caring nurse, my role will be to caution the nurse colleague and ensure that the quality of
care for the patients is not hampered. Entrenching error reporting strategies is key to ensure that
there is an effective level of approach in care delivery. Approaching the nurse and explaining the
error is about to be committed is an essential aspect which signifies being responsive and caring for
the good fare of both the nurse and the patient. Most often challenges in error reporting entail
strong fears of reprisal, disciplinary action and developing negative effects on the interpersonal
relations with the staff and colleagues in the care setting. There is a need for me to overcome such
avenues and ensure that these errors are reported and action is taken to promote patient safety
reduce the occurrence of complications (Andersson, Salickiene & Rosengren, 2016).
Being a responsible nurse illustrates aspects of care and is concerned about the patient's
being. There is a need for enabling other health care staff an opportunity for self-improvement and
care quality management aspects in care delivery. Prevention is better than cure, thus ensuring that
these medication errors are not committed through prompt reporting and notification on the nurse
will be critical and ensuring that patients receive quality care to patients. This will also improve an
avenue where nurses can learn from another through errors and mistakes in the care delivery, in this
way we improve the overall quality and skills in delivering care processes in the health care
institutions.

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Skills
Cultural awareness
Health care practitioners globally are required to deliver care in a manner that is culturally and
linguistically appropriate. Problems linked to patient cultural diverseness such as engaging and
cultural issues are the greater threat in the care delivery and safety of patients. Entrenching cultural
competence in the nursing care delivery calls for a multidimensional construct that recognizes the
sensitivity of culture, awareness, and competence and having n understanding of cultural factors
that influence the behavior and beliefs of the patients (Kaihlanen, Hietapakka & Heponiemi, 2019).
In my placement practice, engaging with patients of diverse cultures and origins was
fundamental for me to entrench aspects of developing cultural awareness. In my training period, I
encountered care delivery for three patients with three divergent cultures. Developing cultural
awareness in this process was crucial. It entailed releasing personal presumptions and assumptions
of other persons. It entails awareness of cultural diverseness and having an understanding of human
caring as a critical aspect of nursing practices (Long, 2012). Being aware of diverse cultures initiates
the steps of being culturally competent which is a critical element in the nursing carrier.
The need for consideration of moral significance in various cultures is paramount, culture
drives and offers meaning in the manner in which illness, suffering, and death to an individual. It
guides on the character, values, duties, and behavior of patients, (Eubanks et al.,2019). As a nurse
and the general health care provides need thus to have a connection spiritually and holistically to
embrace diversity and fundamental melting point for humanity care. The fundamental power of
awareness of culture is key in understanding the needs of patients irrespective of the inherent
backgrounds, which allows gaining more wisdom and gaining knowledge for future practices towards
respecting each other in the care practice.
Attention to details
As a nurse adhering to critical skills that need to be incorporated in the care process tends to
affect a positive outcome in the delivery process outcome. Among the many skills nurses need to
adopt, attention to detail adherence is fundamental as it entails actions concerning either life or
death and sickness during the care process. Action undertaken in the care process plays a
fundamental role and far-reaching consequences in the care delivery process. It is critical for us as
nurses to mind strict attention to detail to avoid making mistakes in the care process. Absent-
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minded writing of patient details could have a negative impact and consequence on the care delivery
process (Park & Chang, 2019).
In my clinical practice placement, the key aspects of developing attention to detail were
characterized in the event where a patient we were co-managing with other colleagues on
placement, was administered less volume of normal saline infusion than the stipulated and required
volume. When the nurse manager was moving around cross-checking how we were progressing, this
neglecting of care and failure to pay detailed attention to patient prescriptions were identified.
Luckily enough we still had an opportunity to ensure that coercive measures are undertaken. From
this incident, I learned that there is a need for paying and ensuring there is a maximum
concentration on patient care in the delivery care process. This will be visible especially towards this
new role in the organization especially in the acute care setting where any minimal error could have
devastating effects on patient care. thus in this new role enhancing interdisciplinary cooperation and
working as a team is an essential avenue of ensuring key and finer details prescribe inpatient care is
adhered to. This is key in improving and providing safe and quality care for the patients in the care
facility and enhances my skills and abilities as a local nurse practitioner in the health care world.
Critical thinking
Critical thinking is an essential skill in nursing practice. The acquisition of this skill in the
placement period was essential in the delivery of care to a patient with multiple disease states. In
my care process, in an incident of care process offered to patient X having multiple diagnoses of
severe chronic pulmonary diseases which led to the development of shortness of breath. The patient
had also type 2 diabetes. Due to the patient deteriorating state, the patient was supposed to be
offered hourly mentoring and paying close attention to the shortness of breath aspects. Due to her
diabetic state, the patient insulin levels often led to signs of unconscious coupled with shortness of
breath which was critical in the care process. In my critical skills aspects, care for their patient as
critical and essential. Requesting for adequate insulin and oxygen support line for the patient was
essential in ensuring that any emergency help for the patient was available.
In this process, enhancing critical reasoning skills is essential for providing care for the patient.
This case incidence in my placement period offered me with skills essential for considering which the
most urgent care needs for the patient are. Having adequate insulin stocks and close monitoring on
the patient's progress was vital in ensuring that the patients are well stable despite the clinical
complication being managed. Developing and enhancing this skill in my carrier as a nurse is
fundamental in assessing care needs and priorities for patients to ensure increased patients safety
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and quality of care. Entrenching this skill will be vital in this role as it involves higher physical
demand which requires adequate critical thinking to balance between patient’s safety and quality
and self-management practices. Working in collaboration with other health workers and improving
my skills in the care process is fundamental in this new role.

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References
DixonWoods, M. A. R. Y., Bosk, C. L., Aveling, E. L., Goeschel, C. A., & Pronovost, P. J. (2011).
Explaining Michigan: developing an ex post theory of a quality improvement program. The
Milbank quarterly, 89(2), 167-205.
Dixon-Woods, M., McNicol, S., & Martin, G. (2012). Ten challenges in improving quality in
healthcare: lessons from the Health Foundation's programme evaluations and relevant
literature. BMJ Qual Saf, 21(10), 876-884.
Lu, H., Zhao, Y., & While, A. (2019). Job satisfaction among hospital nurses: a literature review.
International journal of nursing studies.
Dagget, T., Molla, A., & Belachew, T. (2016). Job related stress among nurses working in Jimma Zone
public hospitals, South West Ethiopia: a cross sectional study. BMC nursing, 15(1), 39.
Wahr, J. A., & Merry, A. F. (2017). Medication errors in the perioperative setting. Current
Anesthesiology Reports, 7(3), 320-329.
Choi, I., Lee, S. M., Flynn, L., Kim, C. M., Lee, S., Kim, N. K., & Suh, D. C. (2016). Incidence and
treatment costs attributable to medication errors in hospitalized patients. Research in Social
and Administrative Pharmacy, 12(3), 428-437.
Andersson, E., Salickiene, Z., & Rosengren, K. (2016). To be involved—A qualitative study of nurses'
experiences of caring for dying patients. Nurse education today, 38, 144-149.
Park, B. H., & Chang, S. O. (2019). A Phenomenographic Approach to Understanding the Expertise of
Perioperative Nurses. AORN journal, 109(5), 612-620.
Eubanks, R. L., McFarland, M. R., Mixer, S. J., Muñoz, C., Pacquiao, D. F., & Wenger, A. F. Z. (2010).
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Festini, F. (2014, December). Family-centered care. In Italian journal of pediatrics (Vol. 40, No. 1, p.
A33). BioMed Central.
American Holistic nurses Association;Holistic Stress Management for Nurses. (2015). Retrieved from
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Management.
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Kaihlanen, A. M., Hietapakka, L., & Heponiemi, T. (2019). Increasing cultural awareness: qualitative
study of nurses’ perceptions about cultural competence training. BMC nursing, 18(1), 1-9.
Kaur, D., Sambasivan, M., & Kumar, N. (2013). Effect of spiritual intelligence, emotional intelligence,
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Ling, T. (2010). How do you get clinicians involved in quality improvement?: an evaluation of the
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