Introduction:

Community health nursing focuses on providing health service, preventive care, intervention and health education to communities or population. They are often involved in policy development, as well as coming up with strategies which enhance the health and safety of the people within the community. As a nursing student and also a Registered Nurse, I have a great opportunity to practice as a community health nurse in the site senior center. In my self-reflection narrative, I am going to demonstrate the clinical objectives I have achieved.

 

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

My clinical rotation for Community Health Nursing is at the Stein Senior Center every Wednesday from 9 am to 12:40 pm. As per school’s policy, I dress appropriately with business-like top, pant, clean sneaker, and always accompany by a big smile every times I go to class. I know every student here representing our school, so I maintain professionalism when interacting with the older people by using therapeutic communication, taking responsibilities for blood pressure screening, respecting each individual and maintaining client confidentiality. I prepare and read all the assigned readings before coming to class, and assignments such as taking blood pressure for the older people or presentation are completed within designated time frame. I also participate in clinical conferences and seek guidance from professor, staffs or classmates when needed.

 

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

It is essential for community health nurses to employ analytical reasoning and critical thinking skills when providing care to people within the community. When providing care to the older adults in the senior center, there was not much opportunity for hand-on experience and we were not able to access to the older adults’ medical record. Therefore I collected the older adults’ information through interview and during interaction with clients. I also had the opportunity to assess the impact of developmental, emotional, cultural, religious and spiritual influences on their own health status, and use analytical reasoning and critical thinking skills as I was providing teaching regarding their medications, blood pressure, or other health concerns to them. Because there was no opportunity to administer medications and treatments in the senior center, I assessed and reviewed medications with the senior, and teaching was provided as well.

 

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

Nurses today are providing care to an increasing diverse patient population, so excellent communication skills are required in order to build relationships with patients and provide a higher level of care. The third objective of my Community Health Nursing class focuses on effectively communicating with diverse groups and disciplines by using a variety of strategies regarding to health needs of individuals and family in the community setting. During interaction with older people, I utilize therapeutic communication skills such as active listening, restating, and using open-ended questions to assess their communication needs, allow time to answer my questions, and encourage them to verbalize their feelings. Also, I always bear in mind to be culturally competent and respect the individual’s personal values and beliefs.

 

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

One of our clinical projects was to educate the older people in the community setting about the importance of hydration through presentation. In order to achieve our goal, my another two classmates and I together developed and implemented a teaching plan. In order to get their attention and to know their knowledge about hydration, we made up a pretest and a post-test and had them to finish the questions before our presentation started. We taught about the symptoms of dehydration, told them when and how to seek medical assistance, and oranges and bottles of water were given out to each older adult while teaching them about the food/drink to help hydrate themselves. Even though it was a little frustrating as we found that some of the older adults were not paying attention to our presentation at all, but the outcome for those who took the post-test was inspiring– most of them had the correct answers after the presentation.

 

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

During my clinical rotation in Stein Senior Center, I was able to utilize the computer lab for research. For example, we were using the computer lab to do research for our hydration presentation and printed out information to the older adults.

 

Objective 6: demonstrate a commitment for personal development

One of the biggest commitment for personal development I can demonstrate is the skill of using a manual blood pressure machine. I learned this skill as a nursing student in the associate program. However, I didn’t have many opportunities to use and improve the skill, because during my clinical experiences, we were allowed to use the automatic blood pressure machines. In the Stein Senior Center, I was able to use my own manual blood pressure kits. In order to make sure do it right in the older adults, I practiced taking blood pressure on my parents, siblings, and myself before I was really doing it in the senior center. Now I feel confident to take blood pressure on anyone by using a manual blood pressure cuff.

 

Objective 7: Incorporate professional nursing standards and accountability into practice

During my clinical rotation in Stein Senior Center, I was able to adhere to the professional nursing standards such as American Nurses Standards and Code of Ethics and took accountability into practice when approaching to the older adults. I also strictly complied with agency standards of practice, and held accountable for every actions I did in the senior center as I came contact with the elderly. I was also aware of the assigned agency’s mission. For example, when taking blood pressure, I asked  the older adults if they already signed the consent; if not, consent must be signed before doing so.

 

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

In the senior center, sometimes we might pair up to a assigned task. For example, one classmate and I joined to do stretch training with the older adults, or I paired up with another fellow classmate to take blood pressure on the seniors. During the blood pressure screening, we got a chance to communicate with the older adults, therefore specific client problems were able to be addressed and advice were given. For example, one older adult told me that he drank water only until he felt so thirsty, I taught him that the recommended amount of water to drink for an adult each day is 8 ounces.

 

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

During my stay in the Stein Senior Center, one concern I had for the older adults is lack of companionship, or loneliness. Older adults came to the senior center for free meals, making friends, or enjoying their time of doing exercises or playing music. However, I noticed some of them sitting alone, or eating and reading quietly. Some people told me that they were doing the same thing as they were home, because they lived alone, or family members were busy for making money/going schools. I think older adults need more social and family support.

 

Conclusion:

I had a great clinical experience in the Stein Senior center. I learned the difference between working in the hospital setting and the community setting, as the community health nursing confronts with more challenges but entails more autonomy and independence. The experience has greatly broadened my knowledge by providing me more insights into the impact of community health nursing in terms of policy making, health prevention, health promotion, and health education to the community. I also appreciate for the opportunity to work with my fellow classmates as a team to provide care and teaching to the older adults in the site senior center, as well as working together to finish our presentations and windshield survey. I recognize that the importance of teamwork also applies for community health nursing; it can help prevent errors from occurring, reduce issues lead to burnout, and provide us with emotional and physical support, so that we can better serve our clients and provide high quality of care.