Objective 1
While coming into clinical site, I make sure to dress in appropriate professional attire. For instance, no jeans, sneakers, sports pants or shirts instead I was wearing black pants with black shit and professional shoes. Sometimes while it was cold, I could put black sweater on top. Any communications with professor, classmates, patients, and facility workers was done in respectful and professional manner. No slang, cursing, racially or sexually inappropriate langue were used. This rule cover not only verbal communication but during emails exchange, phone messages and phone calls. I make sure to come into clinical on time and prepared my material for pre-conference discussion.
Objective 2
As nursing students, we were helping Public Health department in facility to provide teaching sessions for pregnant women on different stages of gestation. The population was diverse by age, ethnicity, race, religion, and socio-economic status. Despite teaching basic material we try focus on individual needs of each patient and provide interventions most suitable for specific person. For instance, many of women primary speak Spanish and had no or limited understanding in English. So, I asked my classmate to help me with teaching, sometimes she just translates what I am saying and sometimes we were teaching together. Moreover, I discovered that having another female with me during teaching session make women more open to share their concerns.
Objective 3
Nurses must use therapeutic communication and speaks with patient and clinical staff professionally and respectful. As was mentioned above I used my classmate’s assistance to overcome language barriers and make sure my patients understand information I teach them. Also, I did my best to make sure my teaching session conduct in nonjudgmental way and respectful to cultural and religious belief. Sometimes it is easy to project own values on somebody else. As health professionals we must be aware of our biases and try to look on situation from patient prospective. For instance, I am non-religious person but most of my patient were people for whom religion is extremely important part of their daily life. In order to provide effective teaching and be able to help them I had to incorporate their belief into my interventions. Also, I tried did my best to not show my biases and be as objective as possible.
Objective 4
My teaching sessions were in the waiting room while women wait for their appointments. It is not the best environment for teaching foe few reasons. First you never know when patient is going to call for appointment and your teaching will be abrupt. Second obvious lack of privacy in such environment make many patients hesitate to collaborate and asking questions. We try to make education as effective as possible by dividing material between us and make it short and straight to the point. Each student was responsible for specific section and we collaborate and help each other when it was necessary. Material for teaching we usually receive form our professor and Public Health worker in facility. In addition, each of us research own topic by using academic journals and peer review studies. I personally liked to use NEJM and Lancet.
Objective 5
Information technology became integral part in healthcare and education. Most of the time I use information technology to find material to prepare for class. Also, I use apps like Medscape and Merck manual to quickly review material in case I forget anything. We did not have any exposure to any EHR programs like Epic or Athenahealth this semester. However, our professor discussed general rules to protect patient confidentiality while using EHR such as do not share on password with anybody, log out while leave computer, and use only protected software.
Objective 6
Community health is important part of health system. I always understand importance of prevention which more efficient way is to keep population healthy. I never personally see myself in public health my goal is make career in critical care. However, I understand importance of community health interventions and learn a lot of useful information that I can use even by caring about critical care patients. Acute care settings is not only performing CPR and run codes, it is also large amount of teaching involve. You need to reach family and patient best practices for recovery and to make them have reasonable expectations based on information nurse provide. Teaching experience that I received during semester can be used in any health settings I am going to work.
Objective 7
ANA standards can be divided in two parts. One is code of ethics that show to carry nursing responsibilities and provide quality care. Another is nursing standards which guide standards of practice and determine scope of practice. In generally ANA standards build on principle of patient safety and quality of care. As nurses we have obligations to act in best interest of our patients and provide high quality of care according our scope. For, instance I did not give recommendations to my patient if I did not research question and have quality information or if this was out of my scope of practice. Bad unproven information or inappropriate way of delivering this information can be harmful for patient.
Objective 8.
When we prepare our study sessions, we were discussing educational material with Public Health educator and our clinical instructor. Also, we were divided in groups and as a group we discussed the best way to deliver material to patients. If we had any questions we could ask for clarification from our instructor or Public Health specialist in facility. Many patients were with their facility members during session. Mostly with husbands but often with parents and other family members like uncles, sisters, brothers etc. While present family members were encouraged to participate in session and asking questions. Moreover, importance of education for family members was explained. Once one of my patient’s husband asked me why everybody say he must be present during session. I told him that pregnancy it is not easy time for women, and she goes through many physical and psychological struggle and to have support and understanding in such moment is helpful and beneficial for mother and future baby.
Objective 9
The social determinates of heath became topic in today discourse about healthcare system and health in general. Finally, we accepted premise that its not only about patient responsibility and numbers of hospitals we have. There are outside forces which affect our health and wellbeing. For instance, we teach patient about proper diet to include more fruits and vegetables, avoid high fat food and avoid fast food. However, healthy diet cost money and for millions of people in this country this price unbearable. The same with therapeutic interventions doctors prescribe medication to patient, we teach them how properly use it but none of this matter if patient cannot afford to buy this medication. The problem become even deeper because of absence of universal healthcare. Millions of people do not have insurance in this country and have no or limited accesses to health care include preventative care. During pandemic we often hear recommendations if you have symptoms call your PCP. This recommendation is correct from medical point but again millions of people do not have PCP and only way to receive primary care for them is to go to ER where they expose themselves and others to virus. Healthcare issues cannot be solved without addressing social and economic problems in our society.
