Narrative Self Reflection

This semester, I had the opportunity to learn about community health nursing. I learned that it is important to identify community resources and evaluate community health risks and problems in order to promote health in the community. Having the nine objectives as a guide allowed me to improve my clinical performance. Throughout the clinical semester, I was able to apply the nursing process to the clinical setting, and utilize my communication skills to interact with seniors in the community. My clinical rotation for this course took place at the Stein Senior Center located on East 24th Street, N.Y., N.Y., 10010.

Objective 1: Demonstrates individual professionalism through personal behavior and appearance.

Throughout the clinical semester, I demonstrated individual professionalism by maintaining client confidentiality. As professionals, it is our responsibility to keep client’s personal health secured. Any information I obtained from the client was kept confidential. I made sure to exclude the names of clients and personal information during class discussions. I recorded client’s blood pressure readings and made sure to personally give the sign-in sheet to the director so that it could be stored in a safe place. I assumed responsibility for my own learning by making sure I came prepared to clinical everyday. I made sure to practice my communication skills at home so that I could communicate effectively with the seniors in the senior center. I also made sure I was prepared to educate clients on information they lacked knowledge in. I was accountable for my responsibilities as a student. I made sure to research the tasks that were assigned to me. This included researching the demographics for the Stuyvesant and Turtle Bay community and making follow-up phone calls to organizations. I made sure to arrive to the clinical site on time. I dressed in professional attire and brought my blood pressure cuff, stethoscope, watch, pen and notepad to clinical everyday. My classmate and I were required to prepare presentations for the seniors at the stein senior center and we made sure to complete the presentations within the designated time frame. At the beginning of the semester, I was a bit quiet in clinical conferences but as the semester went on, I began to speak a bit more and I got the opportunity to share my clinical experiences with my instructor and classmates. Lastly, I sought guidance from my instructor whenever I was unsure of a situation, and she provided feedback that was instrumental in enhancing my learning.

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

Throughout the clinical semester, I was able to employ analytical reasoning and critical thinking skills when providing care to individuals by utilizing client interview. While interviewing clients, I had the opportunity to ask them if they were taking any medication. Most of the seniors were taking medication for hypertension and some were unaware of potential side effects. I took this opportunity to provide patient teaching. I spoke to the seniors about a few side effects such as dizziness and feeling drowsy. I had them repeat the side effects so I could assess if he/she understood the information that was provided. Overall, most seniors were able to list the side effects and even asked questions if they didn’t understand. Because we were in a senior center we had no access to client medical records, and we did not administer medication.

Assessing the impact of developmental, emotional, cultural, religious, and spiritual influences on client’s health status is very important. During clinical, I spoke to a Hispanic male who had hypertension. Although I was unable to complete a physical assessment, I was able to collect data regarding his illness. He mentioned that his cultural eating habits sometimes made it difficult to avoid certain foods that are high in salt. I suggested that he could begin by slowly decreasing his salt intake and avoiding some of his least favorite foods that are high in salt. As a nurse, it is essential to acknowledge that client’s cultural values and beliefs are important to the individual and it can impact the client’s understanding of an illness.

When working in the community setting, I made sure to maintain client safety by obtaining the lunch for seniors who had an unstable gait.

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.

Throughout clinical, I utilized therapeutic communication. While communicating with the seniors, I used open-ended questions to give seniors the opportunity to share their feelings. I utilized nonverbal and verbal cues such as nodding to show the client that I was acknowledging what he/she was saying. I asked clients for clarification when I was unsure of what the client was saying. I provided clients with support and relevant information. This included the side effects of medication, housing resources available in the community, and how to prevent falls.

During pre-conference, we spoke about what tasks needed to be done for that day. I communicated clearly and effectively with my instructor, peers, and the staff at the senior center. I recorded the blood pressure readings and made sure to let my instructor know immediately if any client had a high blood pressure reading.

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

This clinical semester, I was able to educate seniors about the importance of staying hydrated. My fellow classmate and I spoke about the importance of drinking 6-8 glasses of water per day. We also spoke about ways we lose water, and foods that contain liquids. During the presentation we made sure the environment was quiet so that the seniors could listen to the presentation. At the end of the presentation, we asked true or false questions to assess the senior’s knowledge on hydration and we gave handouts that contained facts about water.

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

We utilized the computer to research information about the community. We looked to see what resources were available to seniors, and we reached out to different organizations by email and through the phone to see if they could attend the health fair we were hosting for the seniors. We printed out flyers to promote our health fair. We also utilized sign in sheets to record the client’s blood pressure readings and it was handed directly to the director so that it could be kept confidential.

Objective 6: Demonstrate a commitment to professional development.

I am committed to adjusting to the challenges of the independent practice in community health nursing by continuing to increase my knowledge as a nurse. As healthcare continues to evolve, it is important that we continue to learn and remain up to date with new information in order to better care for our patients.

I utilized literature from nyc.gov to learn about the demographics in the community. I also made sure to read my community health nursing book so that I was prepared to interact with clients in the community.

I engaged in self-evaluation by posting blogs and sharing my clinical experience with my instructor and classmates.

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

I utilized the American Nurse Association Standards in clinical and complied with the center’s standards of practice. As a group, we collaborated to host a health fair for the seniors in order to refer them to services and resources available in the community. We each were held accountable for contacting organizations, making flyers, preparing presentations, obtaining blood pressure readings and engaging in activities with the seniors.

I was aware of the center’s mission. The mission of the Stein Senior Center is to provide services to seniors in the community in order to promote wellness.

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

As a group, we collaborated with the staff at the stein senior center to host a health fair. We asked to use their computers to send emails to organizations to see if they were interested in attending our health fair. We made sure to identify health problems in the community. We found the top leading causes of death to be cancer, heart disease, diabetes, and hypertension. We also found that there was a lot of construction in the community and that food and items sold within the area was costly. Learning about the community, helped us to realize that this could potentially impact how seniors took care of their health. To assist seniors in accessing resources within the community, we had members from different organizations attend our health fair. Overall, we had about 37 organizations attend our health fair. By brining community resources to seniors, we guided them towards making appropriate lifestyle choices.

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

I recognized a few gaps in the care system. One being that it may be difficult for seniors to access the community resources due to construction, and cost of resources. Second being that many seniors are unaware of potential side effects of medication. I identified that seniors in the community require patient teaching, and we, as nurses need to advocate for making healthcare resources easily available to all seniors.

Overall, I had an amazing experience at the Stein Senior Center. I learned the importance of recognizing community problems in order to promote health in the community. I also learned a lot from my professor who shared her knowledge about community nursing with us. It was nice to see that our service learning project helped seniors learn about the available resources in the community.