NUR 4010 FA 2013

Nahomie Villette

Narrative Self-Reflection of Service Learning Project

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


Objective 1: Demonstrates individual professionalism through personal behaviors and appearance.

Objective one was fulfilled on a regular basis. I maintained client’s confidentiality by not sharing their personal information with others. During the blood pressure screenings I have the seniors write their names on one side of a paper and I recorded the readings on the other side of the paper. The seniors waiting for their blood pressure to be taken were seated at a distance from those who were having their blood pressure taken. I assumed my responsibility for my own learning by reading ahead

of time assigned chapters and I printed out the power points presentation for that day. I always come prepare for class and clinical. One tuesdays that we were supposed to wear to belly dancing, I wore loose clothing. I participated actively in the clinical activities. I always try my best to complete my assignments within designated time frame. I submitted the midterm and three out of the four blogs on a timely manner. For our health fair, our clinical professor was the “to go person”, she was always available to help and I always seek her guidance. I participated actively in clinical conferences by giving my thoughts and opinions on matters such as choosing a title for our heart health fair, what company to contact in order to get freebies and making a schedule for the day of our health fair. I attended clinical punctually and in accordance with school policy by arriving on time to the clinical. I have one absence but the professor was aware that I wasn’t going to be able to make it. I always dress professionally every time I go to the clinical setting. I always wear black dressy pant and a colored top with dressy shoes.

Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.

Being at the Stein senior care, I didn’t have access to medical records of the seniors. I was able to interview some seniors. They told me stories about their personal life and medical procedures that they have done in the past. I had a pretty good ideas about their medical profile. I was able to assess the developmental, emotional, cultural, religious and spiritual influences on the client’s health status. One of the seniors moved to this country from South Africa; although she is happy here with her daughter, however, she told me that she misses her home in South Africa, where she had a lot of room and yard to roam around and she missed her adopted grandchildren. I was able to assess their religious belief by observing them. Some were wearing a cross around their neck. I observed that during lunch time, some of them pray before eating their food. During the thanks giving dinner, my asian population asked for hot water and hot tea for their beverages. In the asian culture, they believe that hot beverages is very good for ones health. I was able to collect significant data relevant to senior’s self care needs by asking the senior specific questions. I noticed that some of the seniors have either a cane or a walker. I asked them if they have free rugs in the house and I explained to them how that can increase their risks of fall. I told them that they needed to be very careful with these rugs. I was able to complete a partial physical assessment on selected client during blood pressure screening. Due to the location of the clinical, I was very limited as to what I can do on the seniors. I was able to prioritize care based on analysis of data, if a senior have a history to high blood pressure the previous week, I always make it a priority for that senior to get his/her blood pressure check first thing when I come back the next week. Some seniors come to get their blood pressure checked right after belly dancing class, their pressures are normally high. I ask them to go seat down for fifteen minutes and then come back to the blood pressure line. When these seniors come back, they always get priority over the other seniors that normally run low on their blood pressure. I was able to apply priority-setting in planning nursing interventions by performing teachings to the seniors regarding their medications. I was able to implement safe, appropriate nursing interventions in a timely manner by teaching the seniors about how to take their medications every day and how it is important for them not to skip a dose. I was not able to administer medications and treatments at the stein senior center. To evaluate the outcomes of the nursing care, I rechecked the blood pressure of the seniors with the high pressure the previous week. If the pressure has not improved, I told them to go to their doctor and and I put an asterisk next to their name so that Bob can follow up with them in case I do not see that senior the next week. I utilizes principles of personal safety when working in the community setting by keeping the area cluster free.

Objective 3: Effectively communicate with diverse groups and disciplines using a variety of strategies regarding the health needs of individual and families in the community setting.

I utilized therapeutic communication skills with individual in the community setting. When talking to a senior, I actively listen to what they have to say. I always make myself available to the seniors when they need to talk. I communicated clearly and effectively with instructor and peers. If I get a very high blood pressure reading, I asked one of my peers to retake the blood pressure. I communicated significant data to my instructor by making my professor aware of the high blood pressure. I adapted communication skills to developmental needs of the client. I reported and documented assessment such as the blood pressure readings on a sheet of paper and giving it to the my instructor.

Objective 4: Establish 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 in the community setting. We came up with our heart disease theme for our health fair. I provided the seniors information on heart disease and what to do to decrease their risk of having heart disease. I explained the importance of having a balanced diet and the needs to have a regular exercise routine. I established an environment conductive to learning by making the seniors comfortable around me. they talked to me about their families. I found out that a good amount of them were teachers and professors in their young days. The seniors love reminiscing about their life and one can see that through their facial expression. I evaluated client learning outcomes by having them repeat back some of the information I thought them.

Objective 5: Utilize informational technology when managing individual and families in the community.

I utilized principles of nursing informatics in the clinical area by using available to computers to research on questions about the heart health fair. I maintained strict confidentiality with the senior’s information. In the Stein senior center, I didn’t have access to the senior’s health records.

Objective 6. Demonstrate a commitment to professional development.

I used appropriate current literature in planning care for clients in the community setting. We were able to come up with a theme for our heart health fair by looking up at current literature online to see what was affecting the community. I assumed responsibility for a lifelong learning. I did research and came up with a list of questions to ask for our trivia during the health fair. I engaged in self-evaluation by adjusting my methods of teaching through out the semester. I feel better prepare now to be a community nurse. I am committed to adjusting to the challenges of independent practice in community health nursing.

Objective 7. Incorporate professional nursing standards and accountability into practice.

I utilized American Nurses Association Standards in clinical practice. Based on the ANA standards, I collected comprehensive data related to the seniors, I analyzed the assessment data, identified expected outcomes, develop a plan of care and implemented that plan via nursing interventions. I complied with the agency standards of practice. I take full accountability for my actions in the clinical setting. I am fully aware of the stein senior center mission; 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.

Objective 8. Collaborate with clients, significant support persons and members of the health care team

I wasn’t able to collaborate with other health care team to address client problem due to the fact that I was at stein senior care. I coordinated care based on the seniors needs and provided therapeutic interventions. For those that needed their blood pressure to be rechecked before I leave the premises, I asked them to come back after lunch . I identified health care resources for the seniors by referring them to the nutritionist that stein senior center provide. I guided the seniors to make appropriate lifestyle choices. Dieting and exercising is one of my favorite topics with the seniors. During blood pressure screenings, I always take the opportunity to educate the seniors on a balanced diet and regular exercise. I assisted the seniors to make connection to other community agency such as the nutritionist service available.

Objective 9. Recognize the impact of economic, political, social and demographic forces that affect the delivery of health care services.

I recognized that there is gaps in care system , I gave the seniors health informations in simple term/language so that they can fully understand. I began to identify solutions to complex problems in the clinical area by making it a priority to always educate the seniors. During the health fair, I provied informations to the seniors and reminded them that they should see the nutritionist and be physically active, I acted as a change agent in advocating to the appropriate healthcare resources.

I still can not believe that I was part of the team that put together a health fair . I have been to many different fairs and I always thought it was the most difficult thing to do. We had some difficulties along the way, I had such a hard time getting some companies to donate products to the health fair. I contacted many companies and I was turned down. I wrote a letter of demands with the help of my instructor and my peers to purrell. When I didn’t hear back from them, I was very disappointed. On the day of the fair, everything fell into place. We had such a nice turn out. I could not have been more proud of myself and my peers. WE DID IT!!!!. I’ve learned a lot in this community class. With all the knowledge acquired, I’m ready to be a community nurse.