This paper is based on my experience in my community health clinical this semester. It is a reflection of the nine objectives I was expected to accomplish. Although many were met, few were not due to uncontrollable circumstances. This clinical rotation was very beneficial in providing an overview of the role of the Registered Professional Nurse in a community setting.
Objective 1: Demonstrates individual professionalism through personal behaviors and appearance.
Maintains client confidentiality
When speaking and reporting about my assigned client, I used his initials and never disclosed any identifiable information. When using the client’s chart to gather information, I utilized it in a secluded area.
Assumes responsibility for own learning
I assumed responsibility for my own learning, by researching unfamiliar diseases my client was diagnosed with. I also assumed responsibility by doing further investigation on topics by fellow classmates presented to the population as well as the topic I was assigned.
Prepares for clinical learning
I was prepared for clinical learning by having the useful supplies I needed. This included; writing utensils, notepads and any assigned work that was due.
Completes assignments within designated time frame
As for the assigned work my clinical instructor gave, all were completed and presented on their designated due dates.
Seeks guidance appropriately
In the event I needed clarification or assistance, I sought guidance from my clinical instructor as well as the staff at the clinical site.
Participates actively in clinical conferences
Every Wednesday morning, as a group my classmates and I took part in clinical conferences. We discussed an array of topics that not only enhanced my knowledge but shone a light on the professionalism of nursing.
Attends clinical punctually and in accordance with school policy
Every Wednesday I was also punctual, arriving to the site at 8:20am and remaining at the site for the duration of time in accordance with the school policy.
I have never been absent or tardy and I dressed professionally; black slacks, white collared shirt, no jewelry and closed shoes.
Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.
Uses client interview, nursing and medical records, staff nurses and other health professionals to collect client information
The information I obtained was through client interview, the health professionals and the client’s medical record chart.
Assesses the impact of developmental, emotional, cultural, religious and spiritual influences on the client’s health status
By interacting with the client I was able to assess his mental capacity, developmental, spiritual and emotional level and its impact on his health status, as a primary source.
Collects significant data relevant to client’s self-care needs
Through this interaction significant data relevant to the client’s self-care needs were collected, for example the safety needs of the client.
Completes a physical assessment of selected clients/ Prioritizes care based on analysis of data/ Applies priority-setting in planning nursing interventions
Although I was unable to complete a physical assessment on the client due to the environment, the data that was collected allowed for care to be prioritized which was centered on safety and memory deficit.
Implements safe, appropriate nursing interventions in a timely manner
All nursing interventions implemented for this client were safe and performed before I departed the facility.
Administers medications and treatments safely
None of the nursing interventions involved medication administration; therefore I did not administer any.
Evaluates the outcomes of nursing care/ Is reflective about practice. Modify client care as indicated by evaluation of client outcomes.
Every week I returned to the clinical site, I met with my client and evaluated his outcome. The client remained safe and free from injury. Every week I also had to reorient the client to who I was and my reason for being at the facility.
Utilizes principles of personal safety when working in the community setting
When working in the community, I utilized principles of my safety by following the school dress code and removing all jewelry and respecting the personal space of all the clients in the facility.
Objective 3: Effectively communicated with diverse groups and disciplines using a variety of strategies regarding the health needs of individuals and families in the community setting.
Utilizes therapeutic communication skills with individuals and families in the community setting
I utilized therapeutic communication by showing respect for my client, first and foremost. When communicating with my client I spoke to him at eye level.
Utilizes appropriate channels of communication/ Adapts communication skills to the developmental needs of the client
I actively listened to my client even though he has Alzheimer’s disease and many of the things he told me he seemed unsure of. I continued to encourage him to continue to speak without being forceful. We were able to communicate effectively, I got a lot of feedback from him and he even initiated conversation with me.
Communicates clearly and effectively with instructor, peers and the health care team
I was able to communicate with my instructor during the entire time we were at the facility; he was readily available if my classmates or I needed him. I was also able to communicate with the health care team during my time there. They were very helpful and were able to answer any question I had regarding my client.
Communicates significant data to instructor and the health care team/ Reports and documents assessments and nursing interventions accurately
All information gathered and nursing interventions were shared with the health care staff; however, I did not document this information into the client’s medical record chart. I did though; report my nursing care plan I formulated for my client to my classmates. I received a lot of helpful feedback from the health care team, my instructor and classmates.
Objective 4: Establish environmental conducive to learning and use a plan for learners based on evidence-base practice.
Develops and implements a teaching plan for an adult and/or family in the community setting
As stated before, I developed an older adult teaching plan for my client. The nursing care plan was composed of a lot of information I gathered for the client’s medical record chart as well as data from the client and the health care team.
Establish environment conducive to learning
To enhance the learning process, I provided the client with a quiet, well lit, secluded area to teach him. Evidence base practice proves that one factor that must be taken into consideration when teaching adults, is to provide a comfortable environment that is conducive to learning.
Evaluates client/family learning outcomes
It is difficult to evaluate the client’s learning outcome due to his memory deficit. He nods his head and responds to the teaching but I am still unsure if he is retaining the information. The clinical site that I report to is an adult day care program, therefore it is impossible to assess his home for safety, as well as evaluate the client’s family learning outcome.
Objective 5: Utilize informational technology when managing individual and families in the community.
Maintain strict confidentiality with client records
The confidentiality of my client was always kept. When reviewing any records concerning him, I reviewed them in a secluded area, alone. When I discussed my client with my fellow classmates and instructor, I used his initials to identify him. The only people that I discussed significant information with regarding my client were the health care team that directly cared for him, my classmates and instructor. Due to the fact that we are in the day facility we do not have the privilege to interact with the families of the clients.
Utilize principles of nursing informatics in the clinical area
In the clinical area I was able to utilize the principles of nursing informatics. I used database services, textbooks and nursing journals to gather and implement information pertaining to and those that would benefit my client.
Objective 6: Demonstrate a commitment to professional development.
Uses appropriate current literature in planning care for clients in the community setting
When planning care for my client in the community setting I always used current literature to ensure my practice was relevant. I utilized recently published gerontology textbooks, current nursing journals and magazines; I also used science journals provided by my school’s database services.
Assumes responsibility for lifelong learning
I believe that in order to stay current and enhance my knowledge, I must continue to read and make an effort to assume lifelong learning. As a result, I am constantly reading nursing journals, reading articles and new studies. I know that this will not only benefit me, but the patients I care for.
Engages in self-evaluation
As a new nurse I am constantly evaluating myself. I reflect on actions I have done and determine if there was a more sufficient way to perform them. I am always trying to improve by behaviors which will improve my practice.
Is committed to adjusting to the challenges of independent practice in community health nursing
I am committed to adjusting to the challenges of independent practice in community nursing. I keep myself up to date with the current community nursing practices and understand that nursing is moving into the community rapidly.
Objective 7: Incorporate professional nursing standards and accountability into practice.
Utilizes American Nurses Association Standards in clinical practice
In the clinical area I always upheld the American Nurses Association Standard of care. I respected the rights and privacy of my client at all times.
Complies with agency standards of practice
As a result, I practiced safely making sure to follow the policies of the institution while keeping the best interest for my client in mind.
Is accountable for actions in the clinical area
I take very seriously my role as a Registered Nurses as well as a nursing student, therefore I took accountability for all my actions upholding the integrity of myself as well as the educational institution I was representing.
Is aware of the assigned agency‘s mission
The first day my classmates and I arrived to the clinical area, we were introduced to the facility’s mission. Therefore I am aware of my assigned agency’s mission. I also know where I can find the mission in the event I need a refresher.
Objective 8: Collaborate with clients, significant support person and members of the health care team.
Collaborates effectively with health care team to address client problems
I was able to collaborate with the health care team which consisted of the recreational therapist, physical therapist, registered nurse, nurse’s aids, and social workers every week I went to the clinical area. Upon arrival I inquired about any changes the health care team was aware of regarding my client.
Coordinates client-care based on client needs and therapeutic interventions
Along with the health care team, I joined in on the therapeutic interventions they implemented to promote cognitive stimuli. I sang, danced and exercised with my client and the other clients at the adult day program.
Identifies health care resources for client/families & Guides clients/families to make appropriate lifestyle and treatment choices
I was unable to meet with the client’s family, therefore I was unable to identify health care resources or guide the family to make appropriate lifestyle and treatment choices. I was able to guide my client in choosing healthier breakfast choices, but the guiding had to be enforced every week due to the client’s memory deficit.
Assist clients to make connections to other community agencies
Due to the setting and the client’s medical diagnoses no assistance was given to make connections to other community agencies.
Objective 9: Recognize the impact of economic, political, social and demographic forces that affect the delivery of healthcare services.
Recognize gaps in care system
Throughout the semester my classmates, instructor and I have discussed the gaps in the health care system as well as our belief on the contributing factors. A lot of the gaps are related to the lack of funding for individuals that are in need. For example one of the affiliates of the adult day program I attended, will be closing due to the lack of financial support.
Begin to identify solutions to complex problems in the clinical area
One solution to the complex problem would be to get more funding to expand the services provided and increase the cliental at my assign clinical area. This would involve a lot of rallying, petition signing and speaking with elected officials of the area.
Acts as change agent in advocating to appropriate health care resources for client/families
I was unable to act as a change agent in advocating to appropriate health care resources for my client.