Community Nursing

Narrative Self-Reflection of Service Learning Project

Community health nursing has prepared me to be more culturally sensitive and competent in my caring for the clients and their families in the community. I learned to be open-minded and respectful while providing care and promoting health. It was a very gratifying experience and the following is a self analysis of how I accomplished 9 clinical objectives as per the evaluation tool with regards to the Service Learning Project.

Objective 1: Demonstrate individual professionalism through personal behaviors and appearance.

During my clinical rotation at Kings County Hospital Center I demonstrated professionalism by making the client’s health and wellness my priority. I maintained the client’s confidentiality by obtaining the guidelines used by Kings County Hospital Center and complied with regulations instituted by HIPAA laws and the American Nurses Associations code of ethics. Preserving client’s privacy and medical records are my responsibility and I made sure that such was not breached. I assumed responsibility for my own learning by being curious in seeking out learning resource materials, applying critical thinking skills, being self determined and motivated to learning new things and participated in research activities. As a means of expanding my knowledge and embracing new ideas I sought out to communicate with my professor and colleagues. I engaged them to discover shared and new ideas while listening with an open mind. I prepared for my clinical learning by being optimistic, having a positive attitude and being in the right frame of mind to deliver safe care to the clients. Completing assignment at a designated time frame was very important because it demonstrates respect, accountability and responsibility. When necessary I sought out information, advice and assistance from my instructor, clinical staff and colleagues and recognized criticism as a learning goal. I contributed during clinical conferences by asking questions, giving positive feedback, supporting peers, sharing ideas, collaborating and having meaningful engagement as part of a teaching and learning experience. I made it my duty to be punctual and appropriately dressed for clinical as required by the college and as a symbol of respect for the nursing profession.

Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.

To accomplish this objective I applied skillful reasoning and clinical judgment to collect, interpret, analyze and evaluate information provided and obtained from individuals, families, medical records, staff nurse and other health care professionals. I used my critical thinking skills to assess, diagnose, set goals and implement a plan of care that was specific to the individual’s self care needs. Priorities were made based on the immediate need and concerns of the individual and families after a thorough evaluation of information. The client’s ability to be a part of goal setting is crucial and this process was completed by determining the client’s level of comprehension, language barrier, emotional well-being, cultural and religious practices, health status and developmental capabilities. Administration of medication was not recommended at the clinical site. Outcome of nursing care plan and nursing interventions were corroborated and adapted based on the demonstration of the client and family progression and achievement of goals instituted. I employed the principles of self awareness by developing knowledge about the community, be attentive in regards to my surroundings and identified reasons for outburst of violent behaviors.

Objective 3: Effectively communicate with diverse groups and disciplines using a variety of strategies regarding the health needs of individuals and families in the community setting.

Communicating effectively with individuals, families and other disciplines from different cultural and ethnic background is essential for without communication it is not possible to know a person’s needs or how to render care. I employed therapeutic communication by making eye contact with the clients, used open ended questions in the form of simple vocabulary appropriate to their understanding. I spoke slowly, used active listening skills, appropriate body language, showed empathy, respect and employ non discriminative language to establish rapport.  I communicated clearly and effectively with instructor, peers and health care teams by sharing my thoughts, being attentive, trusting, respecting, collaborating, solving problems and making decisions. Critical and relevant information including teachings and referrals to community health centers were documented and reported to the instructor and health care team regarding the well-being of the clients and families.

Objective 4: Establish environment conducive to learning and use a plan for learners based on evidence-based practice.

A teaching plan was developed and implemented based on the client’s assessment, diagnosis and data collection. Ethnic background, cultural and religious beliefs and an optimal approach to learning were considered. I used evidence based practice through research of the most current information to formulate the teaching plan. Teaching materials for example presentation, pamphlets, books and flyers in various languages were made assessable for expanding knowledge. Response to learning was observed, documented and reported to the appropriate personnel. Environment favorable to learning was ascertained by introducing self and by making clear the purpose of my teaching plan. Trust and rapport were established, patient was relaxed, engaged and motivated to learn. The environment was clean, warm and free of distractions. The clients were comfortable and privacy was maintained. Learning outcomes were established as the clients and families demonstration their knowledge and understanding of the information taught.

Objective 5: Utilize informational technology when managing individual and facilities in the community.

Through extensive research I was able to access and obtain a wealth of knowledge and evidence based health information from reputable sources using information technology to appropriately care for the clients and families. Health information related to individuals that was communicated and entrusted to me verbally and from client’s records was kept in strict confidence as required by the American Nurses Association code of ethics and the organization’s privacy principles.

Objective 6: Demonstrate a commitment to professional development.

Evidence based data generated from my research was integrated in my teaching plan to provide safe, optimal and efficient care. I assumed responsibility for lifelong learning by my continued education and research on issues related to the health and wellness of individuals and families in the community. Nurses have a responsibility to initiate continued professional development which will allow us to keep abreast with changes in health care. Through extensive research, an abundance of evidenced based data was found that greatly enhance my knowledge and skills. This knowledge therefore allowed me to be more proficient in providing safe quality care. Ongoing self evaluation helps me to identify my strength, weaknesses and learning needs. As a result I am able to improve my learning skills, capabilities, be more knowledgeable about the future practice of nursing and prepare myself to deliver efficient and safe quality care. I am resourceful in my efforts to continue my personal and professional growth, committed to accepting any changes that may present, and adjust to those changes to better provide care for the clients and families in the community.

Objective 7: Incorporate professional nursing standards and accountability into practice.

I integrated professional nursing standards and accountability into my nursing practice by protecting the individual’s rights, providing safe quality care, preserving the individual’s privacy and confidentiality as stated by the American Nurses Association Standards. I maintained a proficient level of behavior required of my profession and took responsibility for any inappropriate actions displayed in the clinical area. I complied with Kings County Hospital standards of practice and was attentive of the organization’s mission in providing quality health services to a culturally and linguistically diverse population regardless of their ability to pay.

Objective 8: Collaborate with clients, significant support persons and members of the health care team.

Collaborating with the health care team, clients and significant support persons is essential when addressing client’s health care needs and effectively delivering care. I was fortunate to be a part of that coordinating team, whose main aim was working together, supporting, sharing ideas and setting goals, planning, problem-solving, making decisions, communicating and working on issues related to client’s care. Various health sources for example, the social worker, case managers, counselors and nutritionist were available to assist clients with unresolved issues and to formulate a treatment plan that is best suited for the individual and their support persons. I educated the clients and families about making healthy choices and life style changes to improve their health while respecting their cultural and religious beliefs. I provided information about appropriate health care services example clinics and community organizations where clients and families can go for additional support.

Objective 9: Recognize the impact of economic, political, social and demographic forces that affect the delivery of health care services.

There are numerous gaps in our health care system that influence the delivery of care to individuals and families in the community.  Many people are suffering and dying because of the limited health services rendered to them as a consequence of their ethnic background, lack of health insurance coverage, their socioeconomic status, mental and physical disabilities, geographic locations, language barriers, high co-payments, low income status, limited access to services, lack of information, unemployment, immigration status, age, gender and inability to pay. To eliminate these disparities culturally sensitive and easy to understand information must be provided, health education to promote wellness and healthy lifestyles should be made available, improvement in cultural competence and communication including linguistic should be addressed and access to high quality health care made attainable. As a health care provider and advocate I am committed to providing high-quality, optimal and safe care to clients and families without discrimination. Everyone should have access to high-quality, appropriate and safe health care regardless of their socioeconomic status or inability to pay and as a community we must enhance our efforts to achieve that goal.

Community health nursing has afforded me with a tremendous amount of knowledge about caring for individuals and families from different cultural, religious and ethnic backgrounds. I learned to listen attentively, think critically, collaborate with peers and health care team in making decisions, identify and solve problems related to the clients and families health care needs. Community health nursing has helped me immensely to understand, admire and respect the role of the community health nurse in promoting health and wellness, preventing diseases and assisting individuals in making knowledgeable health care choices. As I continue to grow in this profession I am dedicated to expanding my knowledge through education and continued learning.