NUR 4010 FA 2013

Crystal Farquharson

Self-Reflection Statement

In completing the Service Learning Project I have fulfilled nine clinical objectives as per the Clinical Evaluation Tool provided.

In order to demonstrate individual professionalism through personal behaviors and appearance I displayed these eight expected behaviors. I maintained client confidentiality by speaking to clients in a trustworthy manner, providing privacy concerning various problems for example during blood pressure screenings, clients signed their names and I recorded their readings beside numbers and turned them in. I assumed responsibility for my own learning by reading my textbook and doing research especially for the health fair. I did not just rely on my clinical professor alone but I took the initiative to use other sources to provide information. I prepared for clinical learning by making myself available to participate in the various activities that are available to the center where I can learn and have a better rapport with the seniors, to see how I as a nurse can serve the community better. I completed assignments within designated time frame by turning my paper in through the designated safe assign on the designated date and by timely completing my four assigned blogs. I sought guidance appropriately when needed to clarify assignments for example the way in which to do my paper about cholera. I participated actively in clinical conferences by giving ideas on what we can as our main focus for the health fair, which vendors we can invite and different ways to get the seniors involved. I attend clinical punctually and in accordance with school by showing up on time. I dressed professionally by wearing clothes appropriate for my surroundings such as gym clothing for specific classes and professional attire when I would only be doing screenings..


The second objective was to employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting was utilized by the following of these eleven expected behaviors. Although I seldom used client interview, I did use nursing and medical records, staff nurses and other health professionals to collect client information. I assessed the impact of developmental, emotional, cultural, religious and spiritual influences on the client’s health status for example when I met this senior who shared how her culture and spiritual beliefs have an effect on her health status. She was 76 year old Caucasian lady who wanted me to guess her age. I guessed 65 and she was very happy to inform me that she was indeed ten years older. She attributed her appearance to her belief in God and the fact that she tries not to allow herself to worry when problems arise. She had a question about a cholesterol medication she was taking and I was able to provide her with the answer she was looking for and I encouraged her to keep herself informed by asking question and if we are not there that the stein center has many resources that she can use. I collected significant data relevant to client’s self-care needs through blood pressure screenings as we were limited at the stein center in the availability of doing other things. I did not get the chance to complete a physical assessment of selected client because of limitations but I prioritized care based on analysis of data by taking the time out to know the population that the center served such as the percentage of clients in the area that had a high blood pressure and heart disease problems and decided to focus on this population through the health fair as a way to help clients who have this problem. I was able to apply priority-setting in planning nursing interventions by through medication administration education, the importance of taking medication as prescribed by the doctor. Because of the limitations and necessity I was not able to administer medications or treatments.  I evaluated the outcomes of nursing care by checking back within a week to see the changes that occurred and how effective my teaching was. I didn’t get the chance to modify client care as indicated by evaluation of client outcomes because my teaching was understood and effective but I utilized principles of personal safety when working in the community setting by using hand sanitizer and washing my hands when appropriate. I also maintained the client’s personal space in conversation.


For the third objective, I was able to effectively communicate with diverse groups and disciplines using a variety of strategies regarding the health needs of individuals and families in the community setting by demonstrating the following six anticipated behaviors. I utilized therapeutic communication skills with individuals and families in the community setting by my use of paraphrasing, silence, acceptance, smiling, and encouraging reminiscing. I utilized the appropriate channels of communication by reporting to my clinical instructor any problem that arose for example an abnormal blood pressure reading. I communicated clearly and effectively with my instructor, peers and the health care team by my use of respectful verbal communication and email notifications. I communicated significant data to my instructor and the health care team by reporting abnormal blood pressure screenings. I adapted communication skills to the developmental needs of the client providing informative material printed in the client’s native language. I communicated by using simple terms to foster understanding.  I was able to accurately report and document assessments, such as blood pressure screenings, and was able to report my nursing interventions to my clinical instructor. Due to the limitations of the Stein Senior Center setting, I was unable to document my interventions.


In order to accomplish the fourth objective which is to establish an environment conducive to learning and use a plan for learners based on evidence-based practice I developed and implemented a teaching plan for an adult and/or family in the community setting by conducting a Health Fair with a focus on   Heart Health at the Stein Senior Center. Seniors were presented with a host of educational information that covered the sign and symptoms of a heart attack, the importance of eating healthy and the effects it has on your heart and the importance of exercise and taking medications as prescribed. One on one discussions were conducted about diet and my physical instructor came in as a vendor to further educate the seniors on what they can do at home in the comfort of their living room, simplified exercises to provide cardio health. I established an environment conductive to learning by proving many pamphlets and poster and doing trivia’s with giveaways to encourage participation on the part of the seniors. I evaluated client/family learning outcomes by asking the seniors to repeat the information they learned and rewarded them for the right answer.




The fifth objective to utilize informational technology when managing individual and families in the community this was achieved by displaying the following three anticipated behaviors.  I was able to utilize principles of nursing informatics in the clinical area by researching the questions presented to me by the client on my cell phone. I used the app for medication information as well as BMI calculations promptly. I was unable to maintain strict confidentiality with client records since informational technology is not utilized when managing client’s records at the Stein Senior Center.


The sixth objective which is to demonstrate a commitment to professional development was completed by exhibiting the following four expectant behaviors.  I used appropriate current literature in planning care for clients in the community setting by investigating current up to date and reliable information pertaining to the heart on various multimedia sources such as websites, journals.  I assumed responsibility for lifelong learning by continuing to keep myself abreast in the latest evidenced based interventions. I engaged in self-evaluation by composing this self-reflection piece and actively participating in class discussion about our clinical day and doing the four required blog postings.  I am committed to adjusting to the changes of independent practice in community health nursing by furthering my education.


The seventh objective that included professional nursing standards and accountability into practice and this was by exhibited by following the four expected behaviors.  I utilized American Nurses Association Standards in clinical practice by showing respect for client’s privacy, behaving professionally and practicing safely and within the scope of my practice.  I have successfully taught and distributed comprehensive educational materials in accordance with the client’s educational levels, physical abilities and in the client’s native language in order to improve health outcomes for the client.  I complied with agency standards of practice by enforcing compliance with HIPPA requirements when recording blood pressure screenings for the seniors.  I am accountable for actions in the clinical area by practicing safely and within my scope of practice by not handing out medication neither doing any unauthorized procedures. I am aware of the assigned agency’s mission, which is to cultivate friendly relations among the members of the Stein Senior Center and the general public; to provide services with an emphasis on group growth; to share the strengths, and wisdom of senior citizens; and referral services, and to safeguard the health and wellness of senior citizens.


The eighth objective to collaborate with clients, significant support persons and members of the health care team were satisfied by exhibiting the following five expected behaviors.  I was unable to collaborate effectively with health care team to address client problems due to the limitations of the Stein Senior center setting.  I was able to coordinate client-care based on client needs and therapeutic interventions by working with other professionals at the center, such as a social worker.   I was able to identify health care resources for client/family by referring the client to his/her primary care provider in the instance of treatment and medication prescription.  I was able to guide clients/families to make appropriate lifestyle and treatment choices by emphasizing the importance of medication compliance and following a heart healthy diet.  I was able to assist clients to make connections to other community agencies by referring them to the social worker at the Center and the department of health where they are provided with various resources.



The last objective to recognize the impact of economic, political, social and demographic forces that effect the delivery of health care services were achieved by exhibiting the following three expected behaviors.  I recognized the impact of economic, political, social and demographic forces that affect the delivery of health care services recognize gaps in care system such as disparities based on race and ethnicity, socioeconomic status and other factors that persist in the goal towards healthcare. I began to identify solutions to complex problems in the clinical area by enlightening the clients about healthy behaviors and informed them about the importance of preventive services like shots and screening tests that are available at no cost.  I acted as change agent in advocating to appropriate health care resources for client/families by teaching them about the significance of the department of aging and elderly services and other free government programs. I acted as change agent in advocating to appropriate health care resources for client/families by teaching the seniors about the importance of taking the initiative to pursue a healthy life through knowledge of healthy behaviors and preventative care information.



I am much esteemed to declare that this community health clinical experience was very helpful. I did not believe that I would have learned so much and accomplished as much as I have in this class. The ability to successfully organize and implement a health fair for the members of the Stein Senior Center was truly a gift.  I practiced collaboration skills, accessing community resources to aid in the fair and working with a team with one major goal was very enlightening. Doing Blood pressures every week enhanced my skill as well and educating clients on healthy diet and healthy way of life has really empowered me as well. I do believe this experience has added to my becoming a well-rounded nurse. I learned the importance of accountability and practicing within my scope of practice, being confidential and providing privacy. My communication skills have definitely increased by my weekly discussions with the seniors. Their life story will stay with me forever as a motivation to keep doing what I can for the community. This clinical experience was very rewarding and I will continue to build on what I have learned.