My community healthy nursing clinical took place every Wednesday in the Sunset Park Senior center. The demographic of this community consist mainly of Spanish or Chinese speaking senior citizens with a little understanding of English, therefore there was a slight challenge with communication. Majority of the senior citizens we had encounter are very enthusiastic about getting their blood pressure monitored and finding out what it means in relation to their health and I felt that it is great that they are so pro-active about maintaining their health. Throughout this clinical experience I had achieved the nine objectives as following:
Objective 1: Demonstrates individual professionalism through personal behaviors and appearance.
I was able to fulfill this objective by demonstrating individual professionalism through personal behavior and appearance. I was able to maintain punctuality every week and dressed professionally as what the dress code was suggested by our instructor, Mrs. June Scarlett. Consent was obtained every time a client came to us to do a blood pressure reading and the client’s confidentiality was maintained. In addition, I assumed responsibilities for my learning by reading up on hypertension and watching videos on how to perform blood pressure (BP) monitoring to refresh my skills. Assignments such as presentations were completed and presented within designated time frame. I also participated in every clinical conference as it is held weekly with Mrs. Scarlett.
Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.
I was able to meet this objective by weekly interaction with the clients. Nursing and medical record of the client was not available since it is not a clinical or hospital facility and no computers were utilized, however there are BP records that are kept in the center. Therefore the recorded was analyzed and used as baseline data. I did not get to administer any medications, instead medication related questions were inquired. Majority of the client are able to tell me if they are on BP medication, how many time they should take it in one day and if they took any on that day. There were a couple of times where the client’s BP was high so they were encouraged to come back in 30 minutes so they can be reevaluated. Usually the BP reading was lower than the initial reading so the client was encouraged to continue to take their medication as prescribe and to reduce their intake on sodium.
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.
Communication with diverse group was a bit difficult however I believed I was able to communicate with the clients effectively. As the weeks goes by I was able to pick up a few Spanish words and was able to bond with the clients better. I had used hand gesture, speaking in English slowly and used a few Spanish words that I had learned in order to get my point across. For the client to understand what their BP reading is at, I began to write out the numeric value of it and explained to them what the normal values are so they can compare and analysis on their own instead of me telling them if it is good or bad. I was able to communicate better with the Chinese speaking clients since I speak one of the Chinese dialect. It was interesting to find out that there was Chinese people who attend this center but they are usually located in the basement which isolate themselves from the Spanish speaking people who are usually located in the dining area on the first floor. I was only able to utilize therapeutic communication with the client alone as their family members does not attend the center with them. I was able to communicate clearly to our instructor and colleague.
Objective 4: Establish environment conducive to learning and use a plan for learners based on evidence-based practice
This objective is met with the presentations we had provided as a group. On our first day the recreational coordinator Ms. Mulett, informed us on which topic was needed the most for the clients in the center. Therefore research was done on each topics for the purpose of sharing reliable and accurate information with our clients so they can promote a better health and life style for themselves. Ms. Mulett helped us interpret during presentations which was essential to the clients for their learning experience. The location of where we did the presentation was an open environment that is conductive to learning and there was a microphone and speaker placed in the center of the room. This ensured a good field of vision to the materials that was prepared and enhance the ability for the clients to hear what was being taught. The clients were assessed on what they knew about the topic as part of the introduction and as conclusion we ask them what they had learn. Their response indicates that they had received the information accurately.
Objective 5: Utilize informational technology when managing individual and families in the community.
This objective is not applicable within this clinical experience because there are no electronic records for me to utilize. However there are written records of the client’s BP record and strict confidentiality is maintained.
Objective 6. Demonstrate a commitment to professional development
I was able to demonstrate professional development by committing myself to lifelong learning as evident by continuing education in the bachelor’s program of nursing. As nurses, it is essential for us to be up to date with current literature and utilize the information within our practice. In preparation to create the teaching sessions, valid and reliable resources on stress and nutrition was reviewed and it was presented to the clients. I overcame the challenges of my practice in this community by remaining professional despite the communication barrier and continuously self-evaluate myself to see if there are anything else I could change or have done better.
Objective 7. Incorporate professional nursing standards and accountability into practice
Professional nursing standards and accountability was incorporated in this clinical experience. The center’s mission is to serve local resident over the age of 60 years old to ensure that all of their health needs are met. As a community health nursing student, I provided blood pressure monitoring using the standards of practice and as per the center’s policy, consents were obtain before providing the services.
Objective 8. Collaborate with clients, significant support persons and members of the health care team
I was able to meet this objective by collaboration with the client and my colleagues. For example, I was able to communicate with one particular client since I speak Chinese and she had a blood pressure reading that indicated pre- hypertension. Upon on further assessment, I found out that she was not taking any BP medication, therefore I explained to her that it was important to have follow up with her primary care physician (PCP) and to have a discussion on setting a plan for self-monitoring of her BP. I made suggestions to the client which include speaking to her PCP to see if she can obtain a prescription for a BP machine and I encouraged her to take her BP daily and keep a record of it so she can show her PCP on the following visit and then the PCP can decide on the best plan of care for her.
Objective 9. Recognize the impact of economic, political, social and demographic forces that affect the delivery of health care services.
The demographic of this community consist mainly of people with Spanish or Chinese heritage. Based on my observations, majority of the clients in this center does not understand English and that is a potential problem as it creates communication barriers. As the clinical progresses, I realized that the clients in this senior center needed teaching on various topics. For example, I noticed that many clients wasn’t sure whether their BP reading was within normal range therefore I explained to the patient on what the normal values are and I compared it with prior records as a baseline to help interpret the reading. Interestingly, the same clients would ask again in the following weeks whether their reading was good or bad. However, as we do this on a weekly basis, they began to understand and interpret it themselves. I believe that despite the language barrier, the clients will be able to learn new information if it is being reinforced. With this experience I would suggest the center to recruit a health care personnel who speak Spanish and provide BP screening on a regular basis.
Overall, this was a great learning experience for my professional and personal growth. It was the first time I was able to work with the senior citizen population in a professional manner in a community based facility. Although there was communication challenges, I believe my colleague and I were able to develop a therapeutic relationship with them. From this experience I learned that one must be attentive to the needs of the elderly and must be patience because information may need to be repeated as needed.
