The narrative self-reflection piece is important as it lets you review the objectives you are to meet during your community clinical. You are given the ability to take the time to evaluate yourself. Look back upon your time during community clinical granting you the chance to truly recognize your progression as a nurse in a community setting. To identify the health needs of your clients in the community and to acknowledge the importance of your role in providing care.
Objective 1: Demonstrates individual professionalism through personal behaviors and appearance.
I arrived to clinical in casual attire with a clean and tidy appearance. I tried my best to make it on time to clinical while juggling a new nursing job. I came prepared with the proper supplies by bringing my stethoscope, blood pressure cuff, pen, and notepad. Every morning my group and I would have a preconference to discuss the events we had planned for the day at the Stein Senior Center and how our assignments were coming along for community lecture. I maintained a professional and polite demeanor towards my colleagues respecting each group member and what they contributed to the group as a whole.
Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.
One of the activities we performed on a weekly basis during clinicals were blood pressure screenings. This activity was of vital importance as it assessed any possible dangers amongst the seniors. As nurses we are able to use our assessment skills to evaluate whether any seniors were in need of medical assistance as we were able to occasionally catch dangerously high BPs. We also interacted with seniors about their health maintenance as some knew their baseline blood pressure and took their medications in a timely manner. Some seniors didn’t regularly take their blood pressure medications, didn’t have BP readings done, and some were not on any prescribed medications. Also its important to take into account the seniors culture and beliefs especially if they come from a background that may not hold much value in western medicine. These factors raise the importance as nurses to encourage seniors to be participants in their own health and to have a primary care provider.
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.
When working in a senior center one has to take into account the clients you are serving. These are elderly people who have lived a lifetime and are to be respected. This specific age group are prone to losing family, friends, and loved ones due to aging and outliving people in their lives. Communicating with seniors in a respectful manner but most importantly listening to what they have to say as they have a lifetime of stories to share. Being able to listen is a skill every nurse requires being able to do so allows us to learn more about the patient. I think my group and I communicated clearly and effectively with one another. My clinical group split up responsibilities and activities amongst each other.
Objective 4: Establish environment conducive to learning and use a plan for learners based on evidence-based practice.
The Stein Senior Center would usually hold a health fair hosted by City Tech nurses but this semester there was no health fair instead we prepared multiple projects. Each project focused on a different topic like safety, nutrition, and exercise. The projects were presented as games that provided teaching. This allowed the clinical group to interact with the seniors instead of just presenting a lecture. The seniors answered questions whether or not they knew the right answers. This engaged the audience to participate as well as learn things they may have not known. We also handed out pre and posttest for each project to assess the seniors preexisting knowledge and what they learned after.
Objective 5: Utilize informational technology when managing individual and families in the community.
In order to create our project to present for the seniors we used online resources which helped us create an interactive family feud style game created with the PowerPoint software. We used various health websites to accumulate information we needed in order to provide teaching to the seniors. We used the senior centers computer lab to accomplish a lot of our clinical work. We created flyers for our projects with the name of the project, date, and time which was also posted on the Stein Senior Centers website and monthly newsletter. When carrying out the blood pressure screenings the senior’s privacy was upheld. The seniors signed an attendance sheet but blood pressure readings were recorded on the back of the sheet to not expose BP measurements next to any names.
Objective 6. Demonstrate a commitment to professional development
The most up to date information was used for teaching to the seniors. Participating in community health clinical is completely different from clinicals during the associates program. Just as bedside nursing can’t compare to providing nursing to that of a community. It’s important to evaluate one’s self and to recognize my own shortcomings to improve on. I will continue to learn, grow, and progress to be a better nurse as I will be a powerful source and connection to a community of patients.
Objective 7. Incorporate professional nursing standards and accountability into practice
My group and I maintained ANA’s standards of practice as we utilized the nursing process which is the foundation of how we as nurses make clinical decisions. We assessed the community and the seniors from the center gathering information on what aspects of life affected them the most. The topic of safety and a decline in nutrition and physical activity were issues among the seniors. We planned and implemented interactive games and activities that would benefit the seniors and provide an alternative way of teaching. As nurses we have the responsibility to encourage education, safety, health promotion, and self-care which my group accomplished. I made sure to know and integrate the Stein Seniors mission in my own practice as I built a friendly rapport with the senior centers member’s, listened to the wisdom the seniors had to share, and promote their wellness.
Objective 8. Collaborate with clients, significant support persons and members of the health care team
Blood pressure readings were done every single week during clinical no exception. At times we caught blood pressure readings that required immediate medical attention. This has happened where a member’s blood pressure was so high that EMT services were called to bring them to the hospital. This could’ve only been done with the work of the nursing student and help from the professor and facility. Incidents like this only emphasizes the need for nurses out in the community to be a connection to medical services and a resource for prevention. I collaborated efficiently with my team as we planned what topics and projects to present to the seniors. The team leader went out to the community and gathered free food and supplies for the senior center from neighborhood shops. We even had Walgreen representatives come to the Stein Senior Center to give a presentation on medication safety. The promotion of health and wellbeing of a community requires the collaboration of healthcare professionals, community facilities, and neighborhood sponsors.
Objective 9. Recognize the impact of economic, political, social and demographic forces that affect the delivery of health care services
Considering the neighborhood of the Stein Senior Center may deceive many people at first glance as Gramercy Park seems like a place for wealthier inclined residents. The neighborhood does not at all reflect the members of the senior center. The seniors may be struggling financially and come to the senior center for the resources they provide. The senior center has a social worker, nutritionist, strength training classes, low cost meals, workshops, recreational activities, and presentations from various health agencies. Without places like these there would be a widening gap in services provided to the seniors. Nursing students from several schools also participate in clinical at the Stein Senior Center providing their own services with health and education promotion.
Summary
The clinical experience and didactic setting complimented each other as the classroom formally prepares you as a nursing student on the things you need to know for clinical. Lectures didn’t consist of a strict regimen with reading off PowerPoints and chapter readings but with engaging and interactive discussions of the role of the CHN (community health nurse). The CHN really encompasses a broad spectrum of knowledge and skills. The CHN takes into account the whole picture as you assess the community, individualized client care, physical assessment, cultures, beliefs, environment, housing, family, education, and so much more. This course let me recognize my own weaknesses and how I can improve on them. I’m currently a new bedside nurse in a hospital and because of all the regulations and documenting one does it limits the so called “bedside” nursing. This takes away from really knowing and understanding the patient. Doing direct patient care especially in a hospital allows you to see patients at the worst time during their illness. Directing nursing care towards the community is imperative to the wellbeing of patients because home is where one’s health starts and prevention needs to enforced.
