Narrative Self Reflection
On June 2nd 2015, I started my first clinical rotation for Community Health Nursing at the Stein Senior Center. At first, I thought it was going to be demanding, intense and fast paced course but as I followed each objectives that was provided by my professor, the class turned out to be impressive. In this narrative self-reflection, I will be presenting my 9 objectives that I did during my time at the Stein Senior Center.
Objective 1: Demonstrates individual professionalism through personal behaviors and appearance
Demonstrating individual professionalism through personal behaviors and appearance is probably the most important factor when making good first impression. As per school’s policy, I was dressed appropriately in navy polo, black khakis and black shoes. I read all the assigned reading chapters before coming to clinical as instructed by my professor. I maintained professionalism during my interaction with senior citizens by reinforcing my nursing skills during blood pressure screening, therapeutic communication and maintained client confidentiality. In addition, I participated during pre and post clinical conferences and shared my experience with this particular senior citizen who had blood pressure of 192/110. I also completed my assignments within designated time period.
Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.
The second objective is to employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting. I interviewed many senior citizens and observed their developmental, psychosocial, cultural background and religious beliefs. One senior citizen that caught my attention was 67 year old Korean American lady. I was checking her blood pressure and her blood pressure was 192/110. She told me she’s having emotional stress, ate ramen noodles the night before and not taking medications as prescribed. I noticed that she has a medication box but she had mixed her blood pressure medications with other pills. I was able to implement safety by how to properly keep medications by telling her to buy either bigger pill box or multiple pill boxes. In addition, I prioritized her state of health by discussing about further evaluation at the hospital right away because of her elevated blood pressure. Furthermore, I reinforced her to take her medications as prescribed and follow diet that is low in salt. I was able to evaluate the outcomes of nursing care by following up with the client in one week to see if their blood pressure readings have improved and eating foods that are low in salt. I applied personal safety boundaries when working in the community setting by washing hands properly or using hand sanitizer.
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.
My 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 approached each individual at Stein Center by applying therapeutic communication such as restating, accepting, sense of empathy and open-ended questions. I utilized appropriate channels of communication by reporting abnormal blood pressure numbers to my clinical instructor. However, this this task was partially limited by the setting of the Stein Senior Center. When I was working with this Korean American lady with elevated blood pressure, I reported to my professor right away with sufficient and clear information. In addition, I also utilized effective communication through internet by using email. I sent a properly punctuated email to my professor regarding how to post my online assignments. During my time at Stein Center, I wasn’t able to do any translation or interpretation because I didn’t meet anyone from Burma. Thus, I used efficient and clear cut messages to whoever I came across with.
Objective 4: Establish environment conductive to learning and use a plan for learners based on evidence-based practice.
During my time at the Stein Senior Center, I was able to work on a teaching plan to educate seniors about how to control high blood pressure through DASH diet. In order to achieve my goal, Roy and Ruth, two of my classmates helped me with this project. Initially, we researched DASH diet, foods that are included in DASH diet and benefits of following DASH diet. Afterwards, we created flyers and brochures to attract our participants. We decided we should bring in fruits and bread that are under DASH diet and give them to seniors. We also handed out pre and post-test to seniors to assess their knowledge. In the end, we asked them hand in the quizzes and we exchanged those quizzes for fruits and bread.
Objective 5: Utilize informational technology when managing individual and families in the community.
I utilized the resources at the Stein Center, including computer lab to complete our DASH diet presentation and my own personal device, iPhone to search vocabularies, definitions, medications, and epidemiology.
Objective 6: Demonstrate a commitment to professional development
I demonstrated a commitment to professional development by showing empathetic, passionate, kindness and devoted behaviors. In addition, I participated during pre and post discussions and wrote 4 blogs about my experiences at the center. Furthermore, I was able to do blood pressure screening and had opportunities to educate seniors about risk factors of high blood pressure and consequences of not adhering to healthy life styles.
Objective 7: Incorporate professional nursing standards and accountability into practice
During my rotation at the Stein Senior Center, I strictly maintained my nursing duties and protocols, including confidentiality (HIPPA) while I came in contact with each individual senior. Also, code of ethics for nurses was also carried out during my time at the center to reinforce collaboration with other health professionals (clinical instructor, fellow nurses), contributing knowledge and patient education, and promoting safety and rights of the patients.
Objective 8: Collaborate with clients, significant support persons and members of the health care team
At the Stein Senior Center, I was able to participate with my seniors during yoga class, strength training session, and one on one conversation with individual seniors and talked about life stories, needs and concerns. In addition, all of us had an opportunity to assess the neighborhood for safety concerns, transportation, local hospitals and clinics and general living standards. There were social workers that work closely with each senior to make sure they get proper health care, food and other necessities.
Objective 9: Recognize the impact of economic, political, social, and demographic forces that affect the delivery of health care services
During my time at the Stein Senior Center, some of the concerns that I noticed was high cost of living. An average rent for 1 bedroom apartment is approximately between $1900 and $2500. For seniors with fixed incomes or retirement social security, they cannot afford to spend much on their house rent. If they do spend their money on the rent, they will have limited amount of money to spend on their food and other utilities. Therefore, many of the seniors that come to the center will always ask for extra bread or cold packs so they can save their money on food. For this reason, I was able to education to seniors about shopping at whole sale places such as Costco, BJ’s and Target not only to save money on healthy food but also to control high blood pressure through following DASH diet.
Summary
In conclusion, I enjoyed my time at the Stein Senior Center not only because of having an amazing and passionate professor but also experienced completely different atmosphere of senior center in comparison with hospitals and nursing homes. The center itself was absolutely phenomenon and I managed to discover awesome things, including different ethnic backgrounds, war stories from veteran seniors, dancing elderly couple who were married for over 40 years and other seniors who tried to test their luck for extra food from people who serve lunch. I also learned what community nursing truly is and it was a great experience to interact with seniors, their friends and families. In the end, it was a privilege to be part of this clinical group because they were energetic, desire to participate and made this class enjoyable.
