Sonia Preston-Campbell
Narrative Self-Reflection
Introduction-As a student in the RN-BSN program in New York City College of Technology, being in the Community Health Nursing class gives me the opportunity to navigate the community in more details. I am privileged to be assigned to observe and participate in the learning experience in the diabetic clinic in Bellevue Hospital Center. This self-reflection will show how I fulfilled the nine Community Health Nursing Objectives for my clinical. (Fall 2013).
Objective #1 Demonstrates individual professionalism through personal behaviors and appearance
I demonstrated individual professionalism through personal behaviors and appearance by being prepared to attend clinical on time, professionally and appropriately dressed in white button down top, dark bottom and a lab coat as required by the nursing program dress code. After our pre- conference which started at 8:30am and ends at 9:00am, we go to our designated clinics. In the diabetic clinic where I am assigned, the first client is scheduled for 10:00. During this one hour wait, I take the opportunity to familiarize myself with the client and medical history in order to be prepared when the client arrives. The diabetic educator gives pertinent information from the electronic medical record (EMR). When the client arrives, I introduce myself as a student nurse.
Objective #2 Employ analytic reasoning and critical thinking skills when providing care to individuals and families in the community
I focus on the client’s ability to care for self and manage the diabetes. I participate in discussions with the client by asking pertinent questions when asked to do so by the diabetic educator. I help to make suggestions that could bring positive changes in their care, as I remain sensitive to their culture.
Objective #3 Effectively communicates with diverse groups and disciplines using a variety of strategies regarding health needs of individuals and families in the community settings
The needs of the clients were met as the doctors would come to the room to request an immediate appointment for a client newly diagnosed with diabetes to meet with the educator. She would check her schedule and usually meet with the client the next day. The client would be notified by a phone call. Some clients called for a prescription or refill, the educator called the doctor, who called the pharmacy to fill order. Most of the clients I came in contact with spoke Spanish, therefore the Spanish interpreter was utilized for effective communication. When communicating with the clients and their families, I use clear, simple language, I use proper body language by facing the clients. In this clinic the situation, background, assessment, and recommendation (SBAR) process was used.
Objective #4 Establish environment conducive to learning and use a plan for learners based on evidence-based practice
The clinical environment was conducive to learning, in that it was clean, quiet, and well-lit. There were no-one in the room who was not active in the client’s care. There were several boxes filled with literature about diabetes in several languages with bright colored pictures. The clients and I were encouraged to ask questions and received pertinent responses. The educator was willing to impart a wealth of knowledge to us. Clients were taught how to pull up insulin using the insulin pen, then they were expected to perform a return demonstration.
Objective #5 Utilize informational technology when managing individuals and families in the community
I was able to read my text book, conduct internet researches on diabetes prevention, risk factors, and management. The clients are encouraged to search the internet for valuable information on diabetes whenever they have some free time. I was able to access the internet to collaborate with my professors and classmates as I posted blogs and responded to the blogs of the other students.
Objective #6 Demonstrate commitment to professional development
I have demonstrated a commitment to professional development by maintaining and elevating my nursing education as I gain more knowledge on evidence-base practices while utilizing them in my every day practice. I will be more active and assertive in advocating for clients and their families. I am seeking to advance the profession by participating in nursing researches and community activities. I have demonstrated commitment by me attending school in order to be more competent in all areas of the nursing process. I participated in sharing information and vaccinating students during the health fair.
Objective #7 Incorporate professional nursing standards and accountability into my practice
I incorporated professional nursing standards and accountability into my practice by abiding by the hospital standards, policies and procedures. I delivered care that was within my scope of practice.
Objective #8 Collaborate with clients, significant support persons, and members of health care team
I collaborated with clients as they deliver their diabetic logs for the healthcare team to review, and to assist them in their daily care, including medication regime, diet, activities, and rest. Clients are counselled on management of care when necessary. I encouraged clients to attend the diabetes support group on Fridays, where they get the chance to speak with the medical attending, the pharmacist, nurse, and nutritionist.
Objective #9 Recognize the impact of economics, political, social, and demographical forces that affect the delivery of healthcare services
I observed that some clients were economically challenged as they were unable to purchase the right foods for a healthy diet, and also used less of the medication prescribed in order to make it last longer. In this case a referral to the social worker is necessary for possible food stamps, or food pantry, and additional insurance to pay for medications. The medical team being conscientious of their economic status can prescribe less expensive brands of medication. Clients who experience long term stressful situations can be referred to a support group or counseling. On the second floor where the diabetes clinic is located, the hallway is usually crowded as clients and family wait to be called. There are usually not enough chairs, so people stand in along the sides and by the elevators. This affects the flow of care delivery. Sometimes some clients do not wait and return home. This can result in poor management and hospitalization.
Conclusion
As a student in Community Health Nursing (CHN), I was thrilled to be a part of the diabetes clinic experience. I have gained much knowledge in the way the clients are knowledgeable about their condition and their motivation to take care of themselves by testing their blood glucose everyday around mealtime and documenting. I learned to use the insulin pen. I have more insight on the reason some clients are unable to manage their health condition, it is not because they are non-compliant, but it could be lack of knowledge, language barrier, or they just do not have enough finances. The CHN has the opportunity to make referrals as needed, in order to prevent and manage the health of the community. A healthy community will result in a healthy nation.
