Introduction
The Community Health Nursing course within the baccalaureate program for nursing at New York City College of Technology is composed of two components: theoretical and clinical. The theoretical component was completed on campus in a lecture classroom. The clinical component was carried out at various community health facilities. I was placed at an adult day health center that serves the elderly population within the neighboring communities. Throughout this course there were nine clinical objectives to meet through expected behaviors. The following is a self-reflection piece that discusses how I met the objectives.
Objective 1: Demonstrate individual professionalism through personal behaviors and appearance.
Maintains client confidentiality
I maintained client confidentiality by never disclosing a client’s identity. I never discussing client by their name but only by initial (i.e., client Mrs. J). I also abided by HIPPA.
Assume responsibility for own learning
I assumed responsibility for own learning through researching various topics to gain a better understanding when needed. Whenever I had to do a presentation on a health condition I made sure that I fully understood the condition in depth. (i.e, pathophysiology, signs and symptoms, risks factors, diagnostic test, treatments, and complications).
Prepare for clinical learning
I prepared for clinical learning by making sure I knew what was on the agenda for each meeting. Throughout the semester we had a schedule that displayed which student was presenting along with the topic.
Completes assignments within designated time frame
All of my assignments where completed within the designated time frame. All assigned dates for presentations were met punctually along with our weekly clinical journal.
Seek guidance appropriately
I sought guidance whenever I needed clarification. If I was unsure the answer to a question from a client, I asked my clinical professor or staff at the facility.
Participate actively in clinical conferences
I actively participated in clinical conferences prior to meeting with the clients as well as afterwards. During clinical conferences I provided an overview of patient interaction and teaching that took place along with constructive feedback.
Attends clinical punctually and in accordance with school policy
I attend clinical punctually and in accordance with school policy by arriving promptly at 8:30 a.m. every Wednesday.
Dresses professionally
I dressed professionally by wearing business attire to every meeting at the clinical site. My hair was always combed neatly with minimal jewelry and makeup.
Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.
Use client interview, nursing and medical records, staff nurses and other health professionals to collect client information.
This objective was met by establishing a good rapport with client through client interview, staff nurses and other health professionals to collect client information. I was able to gather information about the client’s health condition and their methods of management.
Assess the impact of developmental, emotional, cultural, religious, and spirituals influences on the client’s health status.
I was able to assess the impact of developmental, emotional, cultural, religious, and spirituals influences on the client’s health status by discussing and evaluating how the clients manage and perceive their health. I was able to learn how a client’s culture affected the outlook and meaning of health. I also learned how one’s spiritual and religious beliefs aided in their management of their health. Developmental impacts were seen in the Alzheimer and dementia clients.
Collect significant data relevant to client’s self-care needs.
I collected significant data relevant to client’s self-care needs through presentations related to proper self-care that involved assessing the client’s current knowledge on the topic. Through these presentations regarding self- care, I was able to analyze how much teaching and clarification the clients needed regarding this topic. The clients also represent a portion of the elderly population. Thus, I am able to identify some of the misunderstanding related self- care amongst this population.
Utilize principles of personal safety when working in the community setting.
I utilized principles of personal safety when working in the community setting by wearing minimal jewelry and being aware of my surrounding at all times.
Complete a physical assessment of selected clients
Prioritize care based on analysis of data
Applies priority setting in planning nursing interventions
Implement safe, appropriate nursing interventions in a timely manner
Administer medications and treatments safely
Evaluate the outcomes of nursing care
Is reflective about practice. Modify client care as indicated by evaluation of client outcomes.
The facility was an adult day facility and did not have responsibilities that coincided with the following: complete a physical assessment of selected clients; prioritize care based on analysis of data; applies priority setting in planning nursing interventions; implement safe, appropriate nursing interventions in a timely manner; administer medications and treatments safely, evaluate the outcomes of nursing care; and modify client care as indicated by evaluation of client outcomes. Thus, I was unable to meet the complete criteria of this objective.
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.
Utilize therapeutic communication skills with individuals and families in the community setting.
I utilized therapeutic communication skills with individuals and families in the community setting by conducting presentation and communicating with clients one-to-one and in small groups. Some settings are more appropriate for personal and private issues that the client may not want to share in a group setting.
Utilize appropriate channels of communication.
I utilized appropriate channels of communication through the use of oral presentations, written material, and physical demonstrations. The written material allowed the clients to review the information, which they could also share with the family, friends, and/or caregivers. The physical demonstrations allowed the clients to visualize a technique, which can provide a better understanding.
Communicate clearly and effectively with my instructor, peers, and health care team.
I communicated clearly and effectively with my instructor, peers, and health care team through expressing my thoughts and questions at pre and post conference discussions.
I also obtained or provided clarification on various issues when necessary.
Communicate significant data to my instructor and health care team.
I communicated significant data to my instructor and health care team regarding issues that affected the elderly population directly to determine essential presentation topics. Some of the clients discussed what kind of health conditions they had, while others discussed what conditions thy would like to learn about.
Adapt communication skills to the developmental needs of the client.
I adapted communication skills to the developmental needs of the client by curtailing medical terminology into laymen terms to ensure that clients were able to gain knowledge and understanding on various topics effectively. This is very important when teaching because not everyone has the same reading or educational level.
Report and document assessments and nursing interventions accurately.
I was unable to report and document assessments and nursing interventions accurately as the facility did not have tasks that required this responsibility.
Objective 4: Establish environment conducive to learning and use a plan for leaners based on evidence- based practice.
Develop and implements a teaching plan for an adult and/or family in the community setting.
I developed and implemented a teaching plan for an adult in the community setting by gathering, organizing, interpreting, and presenting data in a manner that was conducive to the client’s ability to learn, retain, and review information as needed. Teaching plans were developed for various heath related topics that affect the elderly population. Each week the client’s were taught through presentations, questionnaires, and return demonstration.
Establish environment conducive to learning.
I established an environment conducive to learning by conducting presentations in a well-lit room with accommodated seating. The presentations were also conducted after the clients completed the activities planned for the morning, thereby ensuring no interruptions.
Evaluates client/family-learning outcomes.
I evaluated the client learning outcomes by assessing the clients understanding through return demonstration and questionnaires. Through theses methods I was able to clarify address the clients questions and responses. This also allowed me to ensure that teaching was effective.
Objective 5: Utilize informational technology when managing individual and families in the community.
Utilize principles of nursing informatics in the clinical area.
Maintain strict confidentiality with client records.
I was unable to utilize principles of nursing informatics in the clinical area and maintain strict confidentiality with client records. This was due to no computer or client record access.
Objective 6: Demonstrate a commitment to professional development. I used appropriate current literature in planning care for clients in the community setting by researching and utilizing information published within the last five years.
Assume responsibility for lifelong learning.
I assumed responsibility for lifelong learning by keeping up to date with published articles and evidence- based research along with upcoming technology.
Engage in self-evaluation.
I engaged in self-evaluation by assessing the effectiveness and determining how to improve the teaching I provided to the clients.
Is committed to adjusting to the challenges of independent practice in community health nursing.
I was committed to adjusting to the challenges of independent practice in community health nursing by being prepared to take on the responsibilities of a community health nurse through research and clarification despite the presenting scenarios. By gaining better understanding whenever needed I was able to become comfortable with setting of the community nurse working independently.
Objective 7: Incorporate professional nursing standards and accountability into practice.
Utilize the American Nurses Association Standards in clinical practice.
I utilized the American Nurses Association Standards in clinical practice by following the code of ethics for nurses. The code of ethics is a constant reminder of the responsibilities and behaviors that a nurse must abide by.
Complies with the agency’s standards of practice.
I complied with the agency’s standards of practice by following their policies and procedures. By complying with the agency’s standard of practice I was able service the clients in a manner that coincided the agency.
Is accountable for actions in the clinical area.
I was accountable for my actions in the clinical area. Being accountable for my actions allowed my clinical professor, peers, and staff of the facility to have confidence that I would be able to provide services to the clients and carry myself in a manner that was acceptable and expected.
Is aware of the assigned agency’s mission.
I was aware of the agency’s mission. It was important to know the mission of this agency because it allowed my actions to be aligned with the agency’s ultimate goal. An understanding of the agency’s mission is important as it ensures that there is unity within the facility.
Objective 8: Collaborate with clients, significant support persons and members of the health care team.
Collaborates effectively with health care team to address client problems.
I collaborated effectively with health care team to address client problems by evaluating and discussing common concerns and conditions of the client. Based on information gained through client interviews, I was able to determine if clients need additional services. In these cases, I communicated this information to the appropriate staff of the facility.
Guided clients/ families to make appropriate lifestyle and treatment choices.
I guided clients to make appropriate lifestyle and treatment choices through presentations which informing them about a variety of conditions along with their signs and symptoms, management, complication, misconceptions, and recommendations.
Coordinates client-care based on client needs and therapeutic interventions
Identifies health care resources for client/families.
Assist clients to make connections to other community agencies.
I was not able to coordinate client care based on client needs and therapeutic interventions, identify health care resources for clients, and assist clients to make connections to other agencies.
Objective 9: Recognize the impact of economic, political, social and demographic forces that affect the delivery of health care services.
Recognize gaps in care system
I was able to recognize the gaps in the care system by discussing health issues and/or struggles in various aspects of the health care with the clients. The clients expressed their concerns with insurance and financial issues related to health care.
Begin to identify solutions to complex problems in the clinical area.
I began to identify solutions to complex problems in the clinical area by discussing issues of concern with the clients and my peers along with their prospective resolution ideas. Some of the clients expressed their views on the unfortunate announcement that the facility was closing.
Acts as change 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 clients.
Summary
Throughout this semester I was able to gain insight about the role of a nurse in the community. A community nurse plays an important role in teaching and prevention within the community. The facility that I was assigned to showed me the importance of having an adult day health center. The elderly population was able to socialize with others while also being in the environment of healthcare professionals. This provides an outlet for the elderly to express their concerns and receive teaching. I looked forward to part-taking the community nursing in the future.
