NUR 4010 FA 2013

This semester seems to have completely flown by in a flurry of papers and exams. But I cannot say that I haven’t learned anything. Looking back I can honestly say that community clinical has helped open my mind to the ins and outs of bringing health care to the community. As I look over the Clinical Evaluation Tool I see that I have accomplished all nine clinical objectives.

The first objective is to demonstrate individual professionalism through personal behaviors and appearance. This was accomplished by making sure I was present and on time to all my clinical dates. I made sure that I was dressed appropriately and carried myself in a professional manner. I participated in patient care as much as possible. I saw no task as being too small. I sought to be as helpful as possible doing whatever tasks my preceptor requested and even when she made no requests I offered my services anyway. I wanted her to know that I was here to learn and be as useful as I possibly could. I did not want to be underfoot or in the way.

The second objective is to employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting. With each patient I encountered I did my own little assessment every time they were called into the office. I took note of their age, race, and emotional state. I tried to get an idea of their religious and cultural beliefs if possible and how significant those beliefs were to them. I used the information I was able to gather to mold how I interacted with each patient. Some were upset by the long wait which increased their blood pressures. Others had difficulty with the language which made them have a hard time answering questions. I observed as my preceptor took the necessary means to make the experience as peaceful and productive as possible. Although I was only allowed to do blood pressures as far as patient care went I still made sure to wash my hands between each patient in order to maintain personal safety and a clean environment.

The third objective is 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. I definitely accomplished this objective! During my four months at Bellevue’s clinic I encountered so many different cultures and races and ethnicities. I meet people from Egypt, Africa, the Philippines, the Middle East, Cuba, bicycle messengers, masseuse’s and the list goes on and on. I don’t think I’ve ever been exposed to such a variety of personalities! I had to tailor my communication methods to best match each new person. Some required translators. I learned that when working with such a variety of cultures, one has to really put their therapeutic communication to work by being sure to ask only open ended questions and avoiding “why?” Sometimes the preceptor would have to ask the same question over using different wording to be sure that she was being understood and to be sure that the patient was giving and receiving the right information.

The fourth objective is to establish an environment conducive to learning and use a plan for learners based on evidence-based practice. I fulfilled this objective by doing my best to help with my group member’s to develop and implement a teaching plan that was aimed at targeting the students of NYCCT pertaining to education on the flu vaccination. We hung posters and participated in a school health fair where we sought to share information with our peers regarding the flu vaccine and other health issues that they might encounter throughout life. We had a table set up with documents and pamphlets and posters filled with information. Flu vaccines were administered on site in the school for students who did not have health insurance. Although the turn out wasn’t stellar I was still happy with the amount of people we were able to reach out to.

The fifth objective is to utilize informational technology when managing individual and families in the community. This objective was fulfilled by utilizing principles of nursing informatics in the clinical area by using my phone to research some of the disorders that the patients came in with. I also maintained confidentiality by being careful with their documents and medical records when I was calling them in the meet with the registered nurse.

The sixth objective is to demonstrate a commitment to professional development. I accomplished this by being sure I was present and ready to work at each clinical experience. Even though I wasn’t able to provide much patient care I made sure that I was alert and that I paid attention to each patient interaction. I observed my preceptors technique and took note of all the pointers she shared with me. She provided me with documentation about vaccines and diet and how to get the best blood pressure reading. She was willing to teach and I was eager to learn.

The seventh objective is to incorporate professional nursing standards and accountability into practice I remained responsible for all my actions in the clinical area. I ensured that everything I did was within my scope of practice and done well. Bellevue’s mission statement was always present in my mind. The Hospital wished to provide the highest quality of care to New York’s population and to deliver health care to every patient with dignity, cultural sensitivity and compassion, regardless of ability to pay. I wanted to live up to that mission statement even thought I was only working in the capacity of a student.

The eighth objective is to collaborate with clients, significant support persons and members of the health care team. Whenever there was an undesirable or unusual reading, the nurse would then confer with the doctors on sight to decide on the next plan of treatment. I enjoyed participating in the meetings and being a part of the brainstorming process.

The ninth objective is to recognize the impact of economic, political, social and demographic forces that affect the delivery of health care services. It was plain to see that not everyone had to same access to different resources. Some patients had work schedules, language barriers or economic statuses that made it difficult to make it to their appointments, go the pharmacy to pick up their medication, or even monitor their blood pressures at home. The nurse did her best to help them. She would call in prescriptions for the patient and work with them to get the best appointment date and time. I liked that they would have the patient bring in their blood pressure machines and match it up with the one in the clinic. This way the patient wouldn’t have to go out and buy an expensive machine just to make sure that they are getting accurate readings. My group also helped by helping to provide flu vaccines for students who did not have health insurance and would otherwise have a hard time receiving it.

In conclusion I had an educational and profitable clinical experience. I enjoyed watching the flow of the clinic and how organized and efficient everyone was. Throughout the past four months, I learned the protocols of doing blood pressure checks, checking INR levels and providing colonoscopy teaching at Bellevue Hospital which I was able to learn. I was glad to meet so many different people and see that despite what may seem like huge differences that we all wanted health. Also participating in the service learning project, I was able to learn so much about the flu vaccine and I was glad for the opportunity to be able to help teach my peers the information I had learned. After taking the time to reflect on this semester, I must say that I am glad with the way my semester went. I learned and lot and was exposed to so much more. I glad I was able to experience health care at Bellevue Hospital.