Introduction

During the fall 2016 semester I had pleasure to take a Community Health Nursing. Course has two parts and one of it is clinical side. My clinical placement was in Stein Senior Center, 340 East 24th Street, NY, NY, 10010 each Wednesday from 9 am to 12:40 pm. I have to admit it is a special place for seniors, and I wish there will be more of them in the city. Each Wednesday when I was there I saw a simile on people face when they saw our group of students taking to them, dancing with them, taking their blood pressure, and serving the meals. The “thank you” that I heart so many times during the day had different meaning each time. Thank you for being here and showing that you care, thank you for bringing the meal, that you I know what’s my BP (blood pressure) is, thank you for exercising with us, thank you for the health fair. Due the opportunity that the school is giving with providing this course I could see different side of nursing, community nursing, that is as much important as hospital nursing. We have to remember that there is much more people in the community that need nursing care and we should be there to help, and serve those in need.

Objective 1. Demonstrates individual professional through personal behaviors and appearance.

Clinical starts every Wednesday at 9 am. I was always present, on time wearing appropriate to the place clothes to show respect to the seniors, people that work in the center, my classmates, and professor. In the beginning of each and every clinical we sit together to discuss the plan for the day, to make sure we rotate our activities and everyone has something to do. During the time in the center I participate in strength exercises, I dance with seniors before meal, I serve the meals, check blood pressure, I was going out to the community to invite and encourage people to join health fair that will take place November 30th, 2016, and I actively participate in all activities that are necessary for the event to happen. All of the information that seniors share with me as well as all of the BP readings were and are maintain confidential.

Objective 2.  Employ analytical reasoning and critical thinking skills when providing care to individual and families in the community setting.

During my time in Stein Senior Center I had opportunity to check members BP, briefly discousse medications with seniors and stress the importance of following medications regimen. Some of the seniors are very open, expressed their physical and emotional problems, while other are coming only to get something to eat and leave soon after dinner.  It may be their personality or culture. I respect both of the behaviors and try to give as much time as possible for those who miss company.

Objective 3. Effectively communicate with diverse groups and disciplines using a variety of strategies regarding the health needs of individual and families in the community setting.

At the time when I was in the Center I had opportunity to interact with the elderly. I participate in strength exercise, as well as serving meals, talking to members. During the meal serving some people are quietly waiting for their turn, other are waving to us in order to bring attention and get the meal first. I always treat all of them with smile, and kind word. At the same time I get back the appreciation of the service and “ thank you”. When it comes to BP checking. I takes longer time and there is no rush. I sit down next to the senior, I give them safe space, making sure my presence does not cause any stress. I introduce myself and I am asking them open ended question to start conversation and break down any tension. Eye contact may be appropriate for some of the cultures. During that time I have opportunity to assess their daily routine, knowledge of the medications that they take as well as if they are aware of their regular BP. Every time I check the BP I notify the person of the reading that I get,and I am letting him or her know if they are in safe range. All of the readings are documented are later left in the center with the staff.

Objective 4. Establish environmental conducive to learning and use a plan for learning on evidence-based practice.

In the community center there is always 100-140 people daily. Learning and teaching opportunity usually takes place before lunch when there is still place to sit, is not that noisy, and patients still can keep their privacy. Teaching is usually one to one, sitting position with close,safe, and comfortable space between member and me. Seniors were taught of the importance of following doctors appointments, taking medications daily, safe ambulation. The level of understanding was checked by giving the feed back of the understand information. Most of the members come daily to the center which gives the opportunity to check with them next week and see if the implement the passed information into their daily routine.

Objective 5. Utilize informational technology when managing individual and family in the community.

It is important to keep all of the information that seniors share with me, other students, and workers of the center confidential. It is a small community of people that know each other and see each other almost every day. When talking to staff, or seniors I make sure I give them adequate space to provide privacy and I did not share any of the information with the people that are not involve in members care. In the clinical area I utilize my nursing information by providing medication teaching, safe ambulation teaching, and checking the BP.

Objective 6. Demonstrate a commitment to professional development.

Teaching about medications, importance of taking it, explaining why we take some of them in the morning and some of them in the afternoon was one of the aspect of the care plan. After that I asked the senior if he does understand my explanation and I asked if he can repeat, or recall what I just told him. Thanks to that activities I was able to assess member knowledge and understanding as well as he could see how much he remembers and understands.

Objective 7. Incorporate professional nursing standards and accountability into practice.

The mission of the Stain Senior Center is “To cultivate friendly relations among the members of the Stein Senior Center and the general public; to provide services with an emphasis on group growth; to share the strengths, and wisdom of senior citizens; and referral services, and to safeguard the health and wellness of senior citizens”.

As a student nurse I respect the mission and I emphasis all of the rules and routines that the center follow in order to provide adequate service, promote health and wellness of the senior citizens.

Objective 8. Collaborate with clients, significant support persons and members of the health care team.

During the clinical I did collaborate closely with my classmates as well as with the administration of the center to make sure all of the seniors that attend the center will be serve with the warm meal, will have access to hot tea or coffee, and will find a place around the table. Having at least once warm meal during each day is very important and a lot of the senior citizens cannot afford it. Places like Stein Senior Center gives opportunity for over 100 people each day to have free nutrition dinner with the cold pack that they can take home.

Me and other students in the group with the help of the professor organized a health fair for seniors in the center. A lot of specialist like:  dentists, pharmacists, PT, OT, lawyer, and others were invited. During that time members of the center were able to get the screening as well as talk to providers and better know them. Most  of the resources were form the neighborhood where Stein Center is located , and where most of the seniors live. Thanks to that providers were able to develop better connection with the seniors, and seniors learn more about the services that are available in the area.

Objective 9. Recognize the impact of economic, political, social and demographic forces that affect the delivery of health care services.

Stein Senior Center is located on the East side of the Manhattan that is well developed and expensive. Most of the people that live in this area are young, single, educated population that is able to afford pricy housing. The number of senior citizens that left in the community is a minority that experience financial struggle.  Thanks to the places like Satin Senior Center people have place to go where they get warm meal, heating during the winter, and cooling during the summer, they have social workers that can help with any research and answer most of the questions when it comes to the houses and insurance coverage. Organizing the Health Fair will help seniors learn about new, affordable, and available places in the area, as well as will provide free care like dental exam, flue vaccines.

 

Summery

The overall clinical experience in Stein Senior Center was very intensive and educative. Serving members every time we were there, planing and making the Health Fair happened, as well as working as a team shows different side of nursing, community nursing. Leaving this semester I know that I did not waste time, I know that I learned a lot and I will use that knowledge in the community as a nurse.