NUR 4010 FA 2013

A. Jorgensen

Self-Reflection: Me Looking at ME

While completing the Service Learning Project at Stein Senior Center I have fulfilled the 9 clinical objectives required of me as per the Clinical Evaluation Tool provided.

The first objective to demonstrate individual professionalism through personal behaviors and appearance was fulfilled on a daily basis, by my exchanges with the staff and members of the Stein center.  I maintained client confidentiality by not discussing their blood pressures with other clients in the Center.  In addition, when giving blood pressure screening to the seniors, we had them write their name in on 1 side of the sign in sheet, and write in their blood pressures on the other side of the paper, in order to protect their privacy.  I assumed responsibility for my own learning by reading assigned power points at my own pace.  I prepared for clinical learning by keeping my observation skills keen and mind open for new information.  I completed assignments within designated time frame, as evidenced by my timely submission of midterm paper and blog postings.  I sought guidance appropriately by asking my clinical instructor, and Stein staff questions about Health Fair and where would be good places to promote.  I participated actively in clinical conferences by sharing my ideas with my classmates.  I attended clinical punctually and in accordance with school policy, as evidenced by me being on time and at the site.  I dressed professionally in slacks, sensible tops and some shoes.

The second objective, to employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting was accomplished by following the 8 expected behaviors.  Although I was able to use client interview, I was not able to use nursing and medical records, staff nurses and other health professionals to collect client information due to the setting at Stein Senior Center.  I was able to assess the impact of developmental, emotional, cultural, religious and spiritual influences on the client’s health status.  To me the sad clients seemed to be in poorer health but than again maybe that’s why they’re so sad.  I was able to collect significant data relevant to client’s self-care needs by observing the client and by asking specific questions about their needs and abilities.  I was not able to complete a total physical assessment of any client.  I was able to prioritize care based on a 1st come 1st served principle when providing blood pressure screenings.  I was not able to apply priority-setting in planning nursing interventions because my only intervention I was able to use was teaching and I used it as needed.  I was able to implement safe, appropriate nursing interventions in a timely manner by teaching the client about how to take their medications at the same time every day.  I was unable to administer medications and treatments safely since it was not permitted at the Stein Senior Center.  I was able to evaluate the outcomes of nursing care by following up with the client the next week to see if their blood pressure had improved.  I was able to modify client care as indicated by evaluation of client outcome by reassessment of the client’s condition the next week and making a recommendation to follow up with the client’s Primary Care Provider, for possible increases in BP meds if it seemed warranted.   I was able to utilize principles of personal safety when working in the community setting by using hand sanitizer between the patients.

The third objective 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 was meet by following the 5 expected behaviors.  I utilized therapeutic communication skills with individuals and families in the community setting such as using silence, accepting, making observations, using narrow yes or no question when needed, restating, reflecting exploring and giving information.  I utilized appropriate channels of communication by addressing the café staff when there was a café issue or addressing my clinical instructor, if there was a school issue.  I was able to communicate clearly and effectively with instructor and peers during conference, expressing my ideas for the fair. There was no health care team.  I was able to communicate significant data to my clinical instructor by reporting abnormal blood pressure readings during screenings and if a vendor could not make the fair I would notify her.  I was able to adapt communication skills to the needs of the client by providing health pamphlets written in the client’s native language or using clear, and loud words that the client is able to understand due to hearing impairments, or simple words due to the clients level of education.  I was able to accurately report and document blood pressure screening values, but I was not able to report my nursing interventions.

The fourth objective to establish environment conductive to learning and use a plan for learners based on evidence-based practice was accomplished by following the 3 expected behaviors.  By having the Heart Healthy Fair at the Stein center, we developed and implemented a teaching plan for an adult and or family in the community setting.   We established environment conductive to learning by giving live teaching session, and health pamphlets.  I evaluated client and their family’s learning outcomes by asking them questions to see if they retained the information they learned during the teaching sessions.

The fifth objective to utilize informational technology when managing individual and families in the community was not fulfilled because informational technology is not utilized when managing client’s records at the Stein Senior Center or at least we did not have assess to it.

The sixth objective to demonstrate a commitment to professional development was fulfilled by exhibiting the following four expecting behaviors.  We used appropriate current literature in planning care for clients in the community setting by researching current informational materials regarding heart health on various websites, such as American Heart Association, and the Center for Disease Control.  I assumed responsibility for lifelong learning by committing to always stay abreast to the new innovations in fitness and health trends.  I engaged in self-evaluation by participating in the Blogs and by writing this self-reflection piece.  I am committed to adjusting to the changes of independent practice in community health nursing by continuing to monitor the trends in health of the community needs.

The seventh objective to incorporate professional nursing standards and accountability into practice was accomplished by following the four expected behaviors.  I utilized American Nurses Association Standards in clinical practice by practicing safely and within the scope of my practice.  I complied with agency standards of practice by enforcing compliance with HIPPA requirements when providing blood pressure screenings for the seniors.  I am accountable for actions in the clinical area by taking responsibility for any actions I’ve done or advise I’ve given.  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 was accomplished by following 4 of the expected behaviors.  There was no health care team to address client problems with, due to the type of institution that the Stein Senior center is.  I was not able to coordinate client-care based on client needs and therapeutic interventions to due the limitations of my practice at the Stein Center.   I was able to identify health care resources for client and family by referring them to their Primary Care Provider, pharmacist, Doctor Oz, websites and a podiatrist.  I was able to guide clients and their families to make appropriate lifestyle and treatment choices by discussing their condition with them and providing them with information regarding treatment.  I referred clients to the social worker in order to assist clients to make connections to other community agencies.

The ninth objective to recognize the impact of economic, political, social and demographic forces that effect the delivery of health care services were fulfilled by exhibiting the following three expected behaviors.  I recognized gaps in care system by recognizing differences in educational backgrounds, and money play a big part on the health, the clients who appeared to be poorer and lower educated seemed to be in worst health than other clients at the center.  I began to identify solutions to complex problems in the clinical area by keeping clients informed about the importance medication compliance and preventative care.  I acted as change agent in advocating to appropriate health care resources for client and their families by providing them with pamphlets and encouraging them to visit websites that could further there knowledge base.

Summary:

I am happy with the over all experience at Stein Senior Center and the success of our health fair. During the semester my classmates and I were able to organize and implement a health fair about heart disease for the members of the Stein Senior Center and the community at large.   I participated in belly dancing and we socialized with the staff and members of the center.  Along the way I learned of multiple sources of obtaining information, how to organize an event, how to get free stuff, and get people to come and speak about disease prevention and health improvement for free.  Holding the health fair, had me reminiscent of my days as a child, when I used to give out food to the community with my mothers church, it was a good feeling.  One major part of being a community health nurse that I learned this semester was the importance of having a rapport with your community, without being viewed as a part of that community you just will not have the trust from the community members needed to make a difference.

 

 

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