Jessica Sylvester
This paper is based on my experience in my community health clinical this semester using the nine clinical objectives listed in the course outline. This is a self-evaluation on how I achieved the objectives that I was expected to accomplish satisfactorily. I expected more from this clinical rotation, although I was able to achieve many of the objectives. I would have liked to be paired with a community nurse and have more one on one patient interaction. We were able to do a lot of teaching which I enjoyed but many times the team was comprised with social workers. This mainly gave us a viewpoint of their role in community health. Overall despite the environmental limits, I was able to make this a successful learning experience.
Objective 1: Demonstrates individual professionalism through personal behaviors and appearance.
Maintains client confidentiality
I have maintained client confidentiality during the semester by using a low tone when discussing concerns with the client. I share information with staff members who were directly involved in the client’s care and reviewed the client’s chart in secluded areas.
Assumes responsibility for own learning
During my clinical experience, I assumed responsibility for my own learning by researching the given topics for presentation on my own time. Before every presentation I would make sure that we had ample information and would research the answers to any questions that I did not know the answers to.
Prepares for clinical learning
I prepared for clinical learning by making a schedule of the presentations and tasks that we were to perform every Wednesday. I was also prepared by having the useful supplies such as writing utensils and notepads.
Completes assignments within designated time frame
During my clinical experience, I completed my assignments ahead of time so that it could be reviewed by the professor and deemed proper for presentation.
Seeks guidance appropriately
I would seek guidance before giving advice to the client or providing teaching that I am unsure of. I would also seek guidance before performing tasks requested by staff, such as making home visits without the professor being present.
Participates actively in clinical conferences
I would ask questions during post conference and share what the day’s experience has provided. I would also share my practice experiences if relevant, and listen attentively to others.
Attends clinical punctually and in accordance with school policy
I would exhibit punctuality by arriving at my clinical site at 8:25am and remaining at the site for the duration of time in accordance with the school policy. I would also use time management to complete tasks on time so that we could proceed to post conference in a timely manner.
Dresses professionally
At every clinical, I would dress professionally by wearing black slacks and a white button up shirt. I would not wear excessive jewelry, make-up, or open toe shoes.
Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.
Uses client interview, nursing and medical records, staff nurses and other health professionals to collect client information
At this facility, I was able to collect patient information through interviewing both client and staff. We did not have access to private medical information, but was able to access general information on the computer.
Assesses the impact of developmental, emotional, cultural, religious and spiritual influences on the client’s health status
Through interaction with the clients on a weekly basis, I was able to gain information regarding their emotional state and cultural preferences. Included with their cultural preferences I also learned about their religious and spiritual beliefs along with how they practice.
Collects significant data relevant to client’s self-care needs
Through one on one assessment, I obtained relevant data on the client’s needs. For example, during a home visit a client stated that she needed help getting meals. We were able to help her apply to the Meals on Wheels program to satisfy her needs.
Completes a physical assessment of selected clients
Due to the environmental restrictions, I was unable to perform a complete physical assessment. Nevertheless, I was able to use assessment skills such as observation, which provided me with valuable information.
Prioritizes care based on analysis of data/ Applies priority-setting in planning nursing interventions
In addition, the data I collected through verbal assessment allowed for the client’s needs to be prioritized such as nutrition, safety, and education.
Implements safe, appropriate nursing interventions in a timely manner
I provided safe, appropriate nursing interventions that were within my scope of practice. I also ensured that if emergent interventions were needed, they were performed in a timely fashion.
Administers medications and treatments safely
Unfortunately, this experience did not provide any opportunities to administer medications or treatments.
Evaluates the outcomes of nursing care
I evaluated outcomes by receiving feedback from the client and observing their return demonstration for accuracy. I also used evaluation by observing if my interventions were effective and gauging if they benefitted the client.
Is reflective about practice. Modify client care as indicated by evaluation of client outcomes.
During post conference most of my reflective practice would take place. I would think about things that I could have done differently, such as a teaching plan perhaps. If during my reflection I believe change is necessary, I would modify my teaching or care.
Utilizes principles of personal safety when working in the community setting
There are several different principals of personal safety that I utilized at this facility such as providing clients with personal space, not wearing excessive jewelry, and not flashing expensive products.
Objective 3: Effectively communicated with diverse groups and disciplines using a variety of strategies regarding the health needs of individuals and families in the community setting.
Utilizes therapeutic communication skills with individuals and families in the community setting
I utilized therapeutic communication skills by using cultural competency. I showed respect and sensitivity, for example: maintaining eye contact.
Utilizes appropriate channels of communication/ Adapts communication skills to the developmental needs of the client
I actively listened to the clients and accommodated to their learning needs such as memory deficits, I repeated information if necessary and gave reinforcement with handouts.
Communicates clearly and effectively with instructor, peers and the health care team
I was able to communicate with my instructor and peers throughout my entire clinical experience. I was also able to communicate with the health care team during my time there. They were very helpful and were able to answer any questions that I had.
Communicates significant data to instructor and the health care team/ Reports and documents assessments and nursing interventions accurately
All information gathered was shared with my peers, the instructor, and the health care staff. The facility did not allow us to document this information into the client’s medical record chart, we were however allowed to give our interventions and receive feedback.
Objective 4: Establish environmental conducive to learning and use a plan for learners based on evidence-base practice.
Develops and implements a teaching plan for an adult and/or family in the community setting
I developed an older adult teaching plan for my clients. The nursing care plan was composed of a great deal of information, based on the general diagnoses, and dispersed as a group teaching plan.
Establish environment conducive to learning
To enhance the client’s learning process, I provided the client with a quiet, well lit, area. A comfortable environment is necessary in order for effective learning to take place.
Evaluates client/family learning outcomes
I was able to evaluate learning outcomes by receiving feedback and observing changes in behaviors based on the teaching.
Objective 5: Utilize informational technology when managing individual and families in the community.
Maintain strict confidentiality with client records
Client confidentiality was always maintained during this experience; I reviewed concerns in a secluded area and used initials to identify any client during conferences. The only people that I discussed significant information regarding any client were the health care team that directly cared for them.
Utilize principles of nursing informatics in the clinical area
In the clinical area I was able to utilize the principles of nursing informatics. I used the internet, textbooks, and nursing journals to gather information for presentations.
Objective 6: Demonstrate a commitment to professional development.
Uses appropriate current literature in planning care for clients in the community setting
When creating teaching plans for the clients, I always used current literature to ensure that my information was up to date. I utilized gerontology textbooks, journals, and magazines that were all printed within the past five years.
Assumes responsibility for lifelong learning
I demonstrated responsibility to lifelong learning by keeping my knowledge up to date using current journals, magazines, and textbooks. I also aimed to improve my practice by focusing on evidence based practice and new studies.
Engages in self-evaluation
As a fairly new nurse, I constantly evaluate myself. I reflect on my practice and teaching in order to find areas where improvement is needed.
Is committed to adjusting to the challenges of independent practice in community health nursing
I am committed to adjusting to the challenges of independent practice in community health. I keep myself up to date with the current issues facing the community and research possible solutions.
Objective 7: Incorporate professional nursing standards and accountability into practice.
Utilizes American Nurses Association Standards in clinical practice
In the clinical area I always upheld the American Nurses Association Standard of care specifically for community health nursing. I would often refer to their website to assess if I comply with their standards while complying with the facility.
Complies with agency standards of practice
I complied with agency standards of practice by practicing safely while being mindful of their policies and the client’s wishes.
Is accountable for actions in the clinical area
I took accountability for my actions while performing as a Registered Nurse and as a nursing student representing our educational institution. I performed with respect and integrity during this clinical experience.
Is aware of the assigned agency‘s mission
The first day of clinical, I was introduced to the facilities’ mission statement and made a copy in case I forgot.
Objective 8: Collaborate with clients, significant support person and members of the health care team.
Collaborates effectively with health care team to address client problems
I was able to collaborate with the health care team which consisted our professor, a VNS nurse occasionally, a social worker, and my peers. We each played a role in the client’s care and worked together to solve any issues that the client voiced.
Coordinates client-care based on client needs and therapeutic interventions
I performed all teaching and interventions therapeutically addressing any deficits that the clients had. We used translators and attempted to create a joyful environment with our presentations.
Identifies health care resources for client/families & Guides clients/families to make appropriate lifestyle and treatment choices
I was unable to meet with many of the clients’ family, therefore I was unable to identify health care resources or guide the family to make appropriate lifestyle and treatment choices. I did however attempt to teach the client effectively and leave pamphlets and handouts so that they may share with their family.
Assist clients to make connections to other community agencies
I was able to assist one of the clients with access to the Meals on Wheels program since she needed nutritional assistance.
Objective 9: Recognize the impact of economic, political, social and demographic forces that affect the delivery of healthcare services.
Recognize gaps in care system
Throughout the semester, we have discussed the gaps in the health care system as well as our belief on the contributing factors. We mainly focused on financial support and its effect on healthcare. I attended a meeting on insurance and learned how the changes will affect the elderly and many facilities in the future.
Begin to identify solutions to complex problems in the clinical area
One complex problem that this facility faced was lack of insurance for the residents. Many residents were not aware of what is available to them. One solution would be to broadcast insurance information via a health fair.
Acts as change agent in advocating to appropriate health care resources for client/families
I was unable to act as a change agent in advocating to appropriate health care resources for my client during this clinical experience.
