During the Fall 2015 semester of Community Health Nursing, I had the opportunity of spending my clinical hours at the Greenpoint Community Health Center in Brooklyn, affiliated with HHC’s Woodhull Medical Center. My time, not only at this clinical site, but throughout my experiences in the Bachelor’s of Nursing program, has broadened my view on what nursing encompasses. Not only have my clinical experiences changed my outlook of nursing as a profession, but they have also helped me to be more aware of my practice as a nurse in the field.
As per the NUR 4010 course syllabus, there are 9 objectives that should be met upon my completion of the course. Although I believe there is always much to be learned about the profession of nursing, I also believe I have successfully met these nine goals throughout my time in the BSN Program as well as during my professional practice as a registered nurse.
Objective 1: Demonstrates individual professionalism through personal behaviors and appearance.
During my time spent at the clinic, I demonstrated professionalism by maintaining client confidentiality of all the patients I assessed. I dressed in a professional manner and was punctual with my attendance. I also asked for help from clinic staff whenever I needed assistance, taking initiative of my learning process. I prepared for my weekly clinical by establishing a good rapport with the clinic staff and attending their weekly staff meeting, where I took notes about clinic concerns and their proposed solutions.
Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.
This objective was met every time I assessed a patient. Each time I have met with a patient, during my clinical rotation and at my place of employment, I have had to use my critical thinking skills in order to assess the patient’s state of well-being, identify any nursing diagnoses, establish goals, implement appropriate nursing interventions, and evaluate outcomes.
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.
Therapeutic communication skills are crucial in the nursing field. At the clinic, as well as at my place of employment, communication skills are necessary in order to interpret any subjective information received during patient assessment. Communication skills are further implemented when this patient information is relayed to other health care professionals. At the clinic, I had the chance to enhance my communication skills with patients in person and over the phone, as well as by communicating with other disciplines. My communication skills were further tested at the clinic, where majority of the patients spoke limited English; they mostly spoke Polish. I had to find ways of communicating with the patients, mostly by utilizing the staff nurses fluent in the language in order to translate.
Objective 4: Establish environment conducive to learning and use a plan for learners based on evidence-based practice.
At the clinic, educating patients was sometimes difficult. The office was frequently busy with many patients, so time with each client was limited. I attempted to make teaching as effective as possible by providing privacy for my patients and a quiet environment with adequate lighting. Whenever I educated a patient in private, I made sure to continuously ask if they had any questions about what was taught. I frequently assessed each patient’s developmental stage and knowledge and tailored my teaching plan to suit their needs. When encountering a diabetic patient for example, I try to assess the patients’ current knowledge of their illness, including how to self-administer their medication. This way, I am able to modify my teaching plans to better suit their needs.
Objective 5: Utilize informational technology when managing individuals and families in the community.
With technology evolving every day, it is important to be up-to-date with knowledge of these systems in order to provide the best care for our patients as well as to promote efficient interdisciplinary communication. Throughout my stay at the clinic, I had the opportunity of familiarizing myself with their computerized system, where vital signs and other pertinent patient information were entered in order to more seamlessly be communicated to other disciplines. This patient information was kept strictly confidential in accordance with HIPAA guidelines. Although my place of employment has yet to be computerized, I have had ample experience with a variety of computerized systems throughout my clinical rotations that I feel comfortable enough to learn should another opportunity present itself.
Objective 6: Demonstrate a commitment to professional development.
This semester’s Community Health Nursing has taught me that learning never ceases. New health information is being discovered daily, and it is important to be updated on the latest progress. I am learning something new every day in the classroom, clinical, and employment settings. This semester has shown me that nursing entails a lot of research, learning, and growth. I have had the opportunity of researching recent literature about diabetes management as well as other illnesses and advancements in health and medicine in order to provide the best possible care for my patients. I expect to continue learning all throughout my nursing career, in both textbooks and on-the-job experiences.
Objective 7: Incorporate professional nursing standards and accountability into practice.
Adhering to ethical standards and nursing codes is always something that is in my mind when I provide care for my patients. Being employed at a substance abuse facility and working with such a vulnerable population in the community, respect for human dignity and rights is something I keep in touch with everyday. For example, I frequently have encounters with patients who wish to leave detox before completing treatment. Although I struggle with the fact that relapse is more than just a possibility once they leave the facility, I also understand that the client has the right to refuse their treatment. I always try my best to be a supportive and informative nurse for all of my patients.
At the clinic and at my place of employment, I always maintain patient privacy and confidentiality. As I care for my patients, I always take into account the responsibilities I have as a nurse, as I am accountable for my actions. I never practice outside of the scope of nursing because my decisions can impact the patient in many different ways.
Objective 8: Collaborate with clients, significant support persons and members of the health care team.
Collaboration is necessary as a community health nurse in order to achieve patient goals. During my clinical, I have had to learn how to work alongside patients in order for them to identify and achieve their specific goals. I also collaborated with other nurses, PCTs, and doctors when providing care for the client as well as to identify whether goals have been achieved, to provide recommendations for care, and to discuss concerns about the client.
Objective 9: Recognize the impact of economic, political, social, and demographic forces that affect the delivery of health care services.
This semester at the clinic has taught me that viewing the patient and community holistically is necessary in order to address different needs. There are many factors that interplay in the healthcare system, and being involved in the clinic has shown me this. Whenever speaking to patients, it is important to keep in mind factors other than medical symptoms. Social, psychological, economic, cultural, and many other factors all affect the patient and influence our interactions with them. For example, I met with a patient at the clinic who had a history of high blood pressure. She was experiencing a trend of consistent high blood pressures even though she had been prescribed medication. She was not keeping up with her medication, however, because of several different factors. This woman could not afford her blood pressure medications. In addition to this, she had a language barrier that prevented her from communicating efficiently with her health care providers. It’s important as nurses to always keep in mind the different factors that play into healthcare.
In conclusion, this semester of Community Health Nursing has taught me a lot about the role of the community nurse. My views on nursing have become more wide-ranging and I have a better perspective on how intricate and complex nursing truly is. Nonetheless, it has only made my love for nursing grow stronger and I am excited to learn more about my new role as a nurse and the many experiences that come along with it.
