NARRATIVE SELF REFLECTION,NUR 4010
Chinyere Nwankwo
Introduction
I enrolled in City tech college of technology in Fall 2016 to attend a community health nursing class depicted as NUR 4010, The course was designed to be hybrid which means partially online and traditional class. It was a 5 credit course consisting of clinical and a lecture. It was a class education about knowledge on community ,my kind of clinical experience was at First step NYC located at 273 Newport Street Brooklyn 11212. The first day of my clinical, I was assigned to a pre K class of four(4) year olds about seventeen in number. During the course of clinical days I was opportune to partake and follow in the activities as per the school curriculum. As the clinical experience continued, I and my group were able to do some heath teaching to the teachers and parents of the students. The self reflection will show how I fulfilled the nine clinical objective as per the provided clinical evaluation tool.
Objective 1: Demonstrates individual professionalism through personal behavior and appearance
In my opinion I demonstrated professionalism through my personal behavior and appearance. I followed the school clinical guidelines and protocols. There are many expected behaviors to be seen when I was in the clinical setting. First was client confidentiality, I made sure that that the young children confidentiality was maintained by not using cell phone and camera while in the class room . I did read ahead of time of the material posted on the blackboard by the professor in order to understand the community and families I will be working with during the semester. The assignments that was given through the course of the semester I posted them within time frame. I seek for guidance from both my clinical and class professor on occasions that I did not understand and they were able to answer my questions and put things through for me .I participated actively in both pre and post clinical conferences because the goals for the day are discussed in pre-conference and during the post conferences. I discussed how I was able to achieve the goal and feedback was give by the professor. I made sure that I arrived at the clinical site on the expected time on any meeting day by being punctual. I dressed professionally during my clinical hours. I and my class mate wore scrubs during the clinical,it helped differentiate nursing student from the regular staffs in the school.
Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.
I successfully employed analytical reasoning and critical thinking skill when providing care to individuals and families in the community setting. I worked in a Pre k of 4 year olds. The client interview I did was getting to know the preschoolers by name through their class teacher. I introduced myself by name to the preschoolers of my assigned class. The teachers in the class gave me information of the student ,the number in the class and showed me the paper that have information of any student with any health condition like any known food allergy. I assessed the preschoolers the developmental, emotional, cultural, religious and spiritual influences on their health status. I found out that majority of the student are on the same level of development according to a four year old. A few needed more attention to accomplish task as fast as others in their class, and during the course of my observation I found out that there was improvement. I completed the task of helping the student with their self-care need, helping them to the bathroom, watch them brush their teeth each morning, clean any spill to prevent fall and by assessing the student each time I entered their classroom. The above expected behavior of three to eight includes collecting significant data relevant to clients self-care need, completing physical assessment of the student, prioritizing care based on analysis of data, implementing safe ,appropriate nursing intervention in timely manner. The next expected behavior is administration of medication and treatment safely. While I was on the school premises there was no incidence that needed medication treatment. The outcome of the nursing care I gave was that the safety of the students was maintained. The tenth expected was to be reflective about the practice and modify care as indicated by evaluation of the outcome. The approach I have had so far has always been good and positive and there is nothing to modify. I utilized the principle of personal safety by using proper hand hygiene.
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.
I was successful to effectively communicate with individuals and families in the community. This objective was made possible through the interactions I had with parents of the preschooler during the fall festival and health fair that was organized by the school. I had the opportunity to have a therapeutic communication , gave them information on Asthma and addressed the concerns of parents that have children living with asthma. The second objective utilizing appropriate channel was also used because I made sure that every communication was first related to my professor before communicating with the staffs of the center to avoid miscommunication . I also communicated effectively with my peers ,this has helped me and my team to work effectively . The next expected behavior was to communicate significant data to the instructor and health care team. I related significant data from my observations based on the of noticed absence of few student in the class and my instructor was very informational and open to my observation. The fifth and sixth expected behavior to adapt communication skill to the developmental needs of the clients and to report and document assessment and nursing intervention accurately was met because I had to communicate with the preschoolers by listening to them attentively ,use word play to narrate readings from story books according to their age.
Objective 4: Establish environment conducive to learning and use a plan for learners based on evidence – based practice
I did fulfill the expected objective of establishing a conducive environment to learn with the plan for learners based on evidence based practice. The environment is already a designed one for learning because it is a school environment ,so my effort was to make sure that all the students were all seated, quite, attentive and listening during the story time. I always called the attention of any distracted student and inquired of anything that might be bothering him or her in order for the student to be comfortable while learning. The learning for the family was done during the fall festival and health fair. I educated the parents about Asthma and its prevention. I utilized different strategies to evaluate learning outcome, this was done by the use of jeopardy game and they were rewarded by receiving health booklets .
Objective 5 : Utilizes informational technology when managing individuals and families in the community.
I was successful in utilizing information technology in the clinical area and this first expected behavior was met by entering my personal data in the organization data base thereby making it easy for them to do background check on me . This is required because of the community and family of the young children that I worked with. I also used the phone technology to download video which was used in yoga training session for the parents of the Preschoolers. The second expected behavior which is strict client confidentiality was met by not taking pictures of the kids while I was doing activities with the kids in the classroom or play ground.
Objective 6: Demonstrate a commitment to professional development
In my perspective my expected behavior towards demonstrating commitment to professional development was met. First I used age appropriate books for the preschoolers ,this was accomplish by some of the activities that I engaged with the student . These activities includes arts and crafts, sing along song in class and during outdoor play. The next expected behavior was assuming responsibility for lifelong learning, this was achieved by next day class rehearsal whereby the student were asked to remember what was done the previous day and the student most time identified formally seen objects, and previous read stories. Another expected behavior was to engage in self evaluation, as a nurse because the site is different from hospital clinical site , I made sure that I worked hard with this young ones because it is a an opportunity to learn new thing and I always look within myself to see how to improve each day. The next expected behavior of commitment to adjusting to the challenges of independent practice in community health nursing is what I will say that I surely did because of the way I have fulfilled the other expected behaviors
Objective 7: Incorporate professional nursing standard and accountability into practice.
I was successful in accomplishing the expected behavior of utilizing the American Association Standards in clinical practice . I complied with the agency standard of practice which is to do no harm and being accountable for my actions. I was governed by the standard of justice, treated all the children with fairness. I was aware of the agency mission which is to get help children get off to a good start ,launch youth into adulthood, stabilize and strengthen families and unlock potential in children and adult with special needs.
Objective 8: Collaborate with clients, significant support persons and member of health care team
I was successful with the expected behavior of effectively collaborating with the teachers to address students problem as well as using therapeutic intervention . I achieved this by being involved in the class room learning and because the population of the 4 year old are easily distracted and easy to throw tantrums. I talked to the students therapeutically by calming them down in the form of taking a deep breath couple of times and most times the student is settled. The next objective, to identify health care resources was met for the families. During the fall festival I and my group made Asthma brochures available for the families and we gave out fliers for free in home fumigation for families that met certain criteria of having a child with Asthma. I had the opportunity to provide guidelines to families on how to make appropriate lifestyle and treatment choices during fall festival and health fair. I provided blood pressure screening, Asthma prevention teaching and papers with health food choices. The preschooler have also been involved in healthy life style teaching made possible by involving them in making vegetable soup which they ate and enjoyed.
Objective 9: Recognize the impact of economic , political, social and demographic forces that affect the delivery of health care services.
I was successful to recognize the impact of economic, political, social, and demographic forces that affect the delivery of health care system. The gaps in care system not only does it affect the health care of the people of the community. It also affect the educational system of the community. There is disparity of academic performance of the people in this community due to their high level of loss school days by the students due to poor living conditions. I identified some solution to complex problems which I cannot do alone because of the logistics involved. To name but a few, some of which are to engage and reach out to students families, conduct adult education and parenting courses at schools. The clinical allowed me to act as a change in advocating appropriate health care resources for families. Lest I forget this morning I encouraged a parent to buy a blood pressure machine to use for monitoring her pressure since her blood pressure fluctuates between acceptable normal and high.
Conclusion
I will say that narrative self reflection using the clinical evaluation is a very helpful tool. I was able to see the progress I made during the course of the semester. This is my first clinical evaluation on myself . It helped me to learn , understand the community better and how I have performed as a nurse outside of a clinical setting. I am very pleased to have enrolled in this course.
