Objective 1: Demonstrates individual professionalism through personal behaviors and appearance.
Our clinical site at P.S. 184 in Brownsville, Brooklyn has taught me a lot about the children and caregivers in the community. My clinical group was divided into four pre-kindergarten classes. With three to four students assigned to each class the students who were between the ages 4 and 5 were able to become familiar with the nurses. Every week we wore our nursing scrubs and greeted the teacher, teaching assistant, and students. We got to know all of the children’s names, assisted with the daily routines of the morning, and worked the students out individually with classwork activities and play. The students became open with communicating their concerns, questions, and overall curiosity. As a nurse breaking down the barriers within the community, by working with children and healthcare professionals are essential in their future. Many people in the community may not feel comfortable in communicating their concerns due to stigmas or inexperience with using health care resources.
Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.
Each day we met the with the students my group and I assisted students in need of their daily routines such taking off their jackets and book bags and preparing for breakfast. We noticed that there were certain students who were unmotivated and very slow to integrate themselves into their daily routine. Some students would not follow directions and require repeated redirection. Using my nursing judgment I would try to communicate with the students to inquire about what events led them to feel this way. For most students the issue was not having a restful nights rest due to going to bed late. Some students had family issues at home, which leads to fluctuations in behavior on the daily and weekly basis. At some points the student would participate and might be completely disobedient in others. By using skills such as active listening and reflection to work through issues, that are preventing the student from being an active member of the class. Even though the brief counseling that we provide on the one to one basis is short, it does helps students build rapport with nurses, teachers, and parents to encourage to speak to others about their feelings and experiences in order to work through them.
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.
Teachers, teacher assistants, school nurses, and parents were involved in helping children identify healthy eating choices and forms of exercise. With healthy eating activity days students were introduced to small portions of vegetables or fruit and were rewarded for trying them. With the permission of the parents and school nurse students with special diets were allowed to participate; however their meals were modified. Afterwards, teachers helped students learn about different facts about the food they were about to eat; such as where and how it was grown. Parents were then given copies of the recipes made in class to be recreated at home. This helped move the effect of the information from the school into the home setting in the community. Parents are encouraged to join cooking classes held at the school every Friday that make affordable healthy meals with instructors as well as provide parents with the ingredients as well as recipes. Group exercise activities were a major collaborative effort that included all students, teachers, and nurses to get up and move. Our group mixed different concepts about nature, wildlife, and the holidays, with exercise. Each class was brought down to the gym to learn, dance, and play each meeting.
Objective 4: Establish an environment conducive to learning and use a plan for learners based on evidence-based practice.
In order for the students to work effectively without out distractions and obstacles the classroom is always kept clean; and room is always made for students to work both individually and as a group. The classroom is divided into several designated areas that serve as a multipurpose space for the class. Activities such as water play, writing, reading, and computers to name a few are located in different corners of the classroom. By creating these work stations students are less overwhelmed, which is common with this age group according to Wong’s Essentials of Pediatric Nursing. Students are also encouraged to be responsible and independent. By allowing students to take on specific tasks to help the class; using incentives such as “scholar dollars” and complements for work done children are positively reinforced and will continue do the activities because of the feelings associated with it.
Objective 5: Utilize informational technology when managing individual and families in the community.
Information regarding activities, events, and the progress and health of students were communicated to parents via the child’s notebooks. Since many of the parents do not have time during the day to meet up in person weekly teachers help notify parents about the statuses of their child. Confirmation if the parents have read and received information is verified by parent signatures in the student’s notebook. Some parents do not respond to email or phone messages. This method helps keep the family in the loop with student as well as their teachers.
Objective 6: Demonstrate a commitment to professional development
Meeting the pre-kindergarten students every week has been taught me the many different roles of the RN in this community. Health and safety are not our only concerns. Students are taught the necessary skills to become well-rounded individuals. Being able to fulfill these roles helped strengthen my professional development as an RN. Children need guidance, patience, and motivation to help facilitate health promotion. With these skills it helps children to become leaders in their own homes and their communities.
Objective 7: Incorporate professional nursing standards and accountability into practice.
By sticking to the nursing standards and accountability measures set by the ANA, my practice has been very thorough and effective with the pre-kindergarten students. Health and safety of the students have been my main focus. For example, by assisting a student with tying their shoes to prevent falls or teaching children to make a habit of washing their hands every time before and after meals, activities, and the bathroom as well as anytime they touch any dirty surface. By assessing, diagnosing, identifying outcomes, planning, implementing and evaluating these various situations I was able to go about assist the students with the best of my ability.
Objective 8: Collaborate with clients, significant support persons and members of the health care team.
Teachers, teacher assistants, clinical instructors, and our group were a crucial part of our team at P.S. 184. Without their help it would virtually be impossible to carry out all of the work done with the students. We worked to together to help set and carry out our goals with effective communication via blackboard, phone, and verbal confirmation. Most teachers helped carryout lesson plans that coordinated very well with our learning objectives for the student of the week. We were also given freedom with planning out the day’s activities within the period between breakfast and lunch. They also gave us advice on methods to help better deliver our message to the students.
Objective 9:Recognize the impact of economic, political, social, and demographic forces that affect the delivery of health care services.
Unfortunately the Brownsville section of Brooklyn is one of the most underserved neighborhoods of the prosperous city of New York. With its distance from the economical hub of NYC in Manhattan, there is a lack of jobs and poor city resource allocation in this area. And with high levels of crime and lower educational backgrounds the mostly African-American and Hispanic population have continued to be left behind. With such obstacles health care services are not as readily used in comparison to more well to do neighborhoods. Travel to appointments and keeping up with outdoor physical activity is met with many obstacles such as safety, higher transportation fees, and lack of education on resources provided in the area. Without intervention from leaders within the community changes cannot be made to make Brownsville a better area for its people.
