Narrative self-reflection by Lyubov Levina-Brooks

 

The course of Community Nursing was very interesting experience. It consisted of lectures and clinical part. My clinical part took place in Sunset Park Senior Center. This senior center provides nutrition, recreation, social and educational services, assistance with  needed information and  medical referrals. In addition it offers new programs such as fitness, Zumba activities, English as second language classes to meet the needs and interests of the seniors living in this area. Our project was to assess this area and we found out that majority of the population are Hispanic and Asian. This center made great number of adjustments to accommodate those seniors’ needs.

I successfully met all the objectives required for this course and in following I will describe it in details.

 

Objective 1:  This objective was to demonstrate individual professionalism through personal behaviors and appearance. I have successfully maintained client confidentiality I never mentioned his/her name or any other details in any other places; and I have never discussed client matters around anybody else. I assumed responsibility for my own learning by making research on clinical related topics, obtaining and studying additional reading. I was prepared for clinical learning by having my required supply such as stethoscope and sphygmomanometer, books and other. I completed and submitted assignments such as power-point presentations within designated time frame and in appropriate format. I was seeking guidance appropriately but asking questions my clinical professor and facility staff. I actively participates actively in clinical conferences, ,reported my observations and actions and made comments and suggestions

I attended clinical punctually and in accordance with school policy and was dresses professionally in clean, professional manner.

 

Objective 2:   To meet this objective I had to employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.

I was collecting client information by interviewing the client, and also finding answers in his/her nursing and medical records, by staff nurses and other health professionals.

I assessed the impact of developmental, emotional, cultural, religious and spiritual influences on the client’s health status, for some practices can lead to health risks. Collecting significant data relevant to client’s self-care needs was done by direct questions and observation of patients grooming and behavior. By some patients, when it was needed I did complete physical assessment using all the skills from previous nursing classes and my experience. Based on analysis of data obtained by assessment I prioritized care according to basic needs and nursing process. I applied priority-setting in planning nursing interventions by discriminating between more critical condition needing immediate attention and less acute situations. All the nursing interventions I choose appropriately and implemented those safe in accordance with policies and rules, considering patient’s condition; and in a timely manner. I did not have chance to administers medications, but I had plenty of talk with patients about their medications and treatments which they get; I assessed their knowledge about it and gave necessary teaching and clarifications. After every intervention I evaluated the outcomes of nursing care I provided by for example assessing changes in patient’s condition or knowledge. Using the evaluation of the outcomes I reflected about practice. In case it was needed I modify client care such as if outcome was not satisfying or sufficient. As much as considered patient’s safety I utilized principles of personal safety as well when working in the community setting by washing hands, using proper body mechanics, obtaining proper immunization, making good research of area before going there and others.

 

Objective 3: I successfully met objective of effectively communicating with diverse groups and disciplines using a variety of strategies regarding the health needs of individuals and families in the community setting.

When interviewing and assessing individuals and families in the community setting I utilized therapeutic communication skills such as open ended questions, listening, non-verbal and other communication techniques. I also utilizes appropriate channels of communication such as flyers, pictures, power-points and others when speech along was not sufficient. My communication with instructor, peers and the health care team clearly and effectively through direct contact, phone calls, email and others. When discovered something significant as for example patient had high blood pressure, misunderstanding of medication, change in condition or other complaints, I communicated this significant data to instructor and the health care team. Depending on the developmental needs of the client I adapted communication skills from medical terms to simple easy sentences. Every finding and every intervention I reported and documented accurately according to course and facility policies.

 

 

Objective 4: For this objective I had to establish environment conducive to learning and use a plan for learners based on evidence-based practice.

In order to develop and implement a teaching plan for an adult the community setting I applied all guidelines from nursing courses and used assessments which I described earlier. Through friendly and professional approach to client I establish environment conducive to learning. During following meetings and interviews I evaluated client/family learning outcomes.

 

Objective 5:  This was objective was to utilize informational technology when managing individual and families in the community.

I did not have chance to utilize principles of nursing informatics in the clinical area for this setting does not use computerized record, but I was handling appropriately all tendered me information. I maintain strict confidentiality with client information, I followed every HIPPA protocol.

 

Objective 6.  I did very well on demonstrating a commitment to professional development.

I utilized college, public and professional library at my work place and used appropriate current literature in planning care for clients in the community setting. I am frequent visitor of those libraries and for lifelong learning I read broad type of literature. I personally proud of stating that no matter how busy my schedule gets I always find little time for reading something developing not only in nursing field. For this course I engages in self-evaluation. In addition this course showed me how many interesting challenges of independent practice in community health nursing are out there and I committed to adjusting to those.

 

 

Objective 7.  The following objective was to  incorporate professional nursing standards and accountability into practice. I read Scope and Standards of Practice  in nursing, which defines the “who,” “what,” “where,” “when,” “why,” and “how” of nursing practice, including advanced practice nursing and utilized it in my clinical. I also obtained, read through agency standards of practice and assigned agency ‘s mission, so I was aware of it and complied with it. My actions in the clinical area were professional and well thought through, so I was always accountable for what I was doing.

 

 

Objective 8.  This objective included to collaborate with clients, significant support persons and members of the health care team

Since I was not in medical setting there was no big health care team to address client problems, but I collaborated effectively with all staff members who were taking care of the clients such activities therapists, social workers and others. In case some were needed I coordinated client-care based on client needs and therapeutic interventions. With some research I identified health care resources for client/families. When during assessment I saw that client needed to make appropriate lifestyle and treatment choices, I aided in this process. Following I assist clients to make connections to other community agencies which will meet their needs.

 

 

Objective 9.  The final objective was to recognize the impact of economic, political, social and demographic forces that affect the delivery of health care services

During the assessment of the area for the service learning project, I obtained large amount of information and I could recognize gaps in care system. It gave knowledge to begin to identify solutions to complex problems in the clinical area. All the learned material in class and in clinical inspired me to acts as change agent in advocating to appropriate health care resources for client/families.

I learned that community nursing is continuing process. It aims to provide evidence-based care and leveraging technology. For success the collaboration across all medical and social disciplines is needed. Together it will be possible to meet the care needs of clients and communities.