Narrative Self- Reflection

Serving as a nurse in the community, has always been a passion of mine. Prior to receiving my Registered Nursing License, I worked in the community as a Licensed Practical Nurse.  Through an agency I worked with parents and children in their home, helping and encouraging them to reach optimal levels of health. This was done by teaching the parents the correct way to administer medication, and properly care for the child who needed a little extra care. In addition to working with the children, I also worked with the parents teaching them ways to reduce stress, encouraging healthy eating, and the importance of resting whenever they had an opportunity to do so.

While in the Community clinical rotation, I once again had  the opportunity to reach out to clients and their families to provide knowledge, assistance, and care. Working in the community allows for the identification of health issues, with a focus on primary prevention and health promotion. Taking part this semester, I made it a point to reach all nine objectives outlined for the course, and met each as follows.

Objective 1

Demonstrates individual professionalism through personal behaviors and appearance. While interacting with clients and family members, I always made certain to maintain the confidentiality of everyone that I came into contact with it. As a nurse, clients and family members trust that you will remain discreet, and keep sensitive information private. I took an active part in furthering my knowledge, by taking the time to read my textbook and other related materials at home, and came in on time and prepared for clinical learning and activities. Assignments were completed and handed in within the designated time frame, and whenever something was not clear to me I reached out to my professor for clarity and guidance. During clinical discussions I listened attentively, and actively participated in discussion. I also, made sure to arrive to the clinical site with the required attire and appropriate footwear.

Objective 2

Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting. This objective was met, and continues to be met by ensuring that I treat every client with courtesy and respect. When interacting with clients, I utilized my interviewing skills to collect any pertinent information. When this was not enough, I proceeded to ask staff members of the facility and other health care personnel for deeper insight. The religious, spiritual, cultural, and emotional well being of each client was taken into consideration and developed, in order for the holistic needs of each client to be met. Data that was pertinent to the client’s history, and collected during physical assessment was recorded, and implemented into their plan of care. Care was then provided to each client, based upon the data that was collected. In initiating the plan of care, interventions were executed based on the needs of the client and what interventions took precedence over the others. These interventions were carried out safely, effectively, and in a timely manner to meet the needs of the clients as best as possible. While administering medications and required treatments, I give them in a timely fashion with the safety of the client in mind. I was able to properly assess and evaluate the outcome of each client by ensuring that their various needs were always met and will continue to be met when they are no longer in my direct care. In the community setting, it is essential to make sure that I am in a safe working environment, before I provide care to a client. This will protect me from any dangers that can arise when working outside of a traditional hospital or facility.

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. When communicating with clients and family in the community, I always make sure that therapeutic communication is being utilized. Therapeutic communication, facilitates trust and fosters a relationship between the nurse and the client. Appropriate channels of communication are properly utilized, by identifying who I want to communicate with, and how they would prefer to obtain information. When communicating with members of the health care team, and in my clinical group I ensure that the message I am delivering is clear and precise which lessens the chances of error and confusion. If during an interview or assessment I notice that something is out of the ordinary or concerning to me, I would communicate this to my instructor and other members of the interdisciplinary team for direction and feedback. Communication skills are adapted to the client based on their developmental needs. This can include speaking to the client in laymen terms, using vocabulary that he/she can understand. When obtaining a history, documentation and possible interventions are recorded accurately to ensure that the client well receive care that is specific for his/her needs.

Objective 4

Establish environment conducive to learning and use a plan for learners based on evidence-based practice. During my current clinical rotation, this objective was met during the teaching plan outlined for the parents and staff at the facility. A presentation was developed targeting the effects of uncontrolled stress, and it’s correlation with hypertension. The presentation focused on ways to reduce stress and anger in this population, and what parents and caretakers can do to alleviate stress and anger in their own lives. The poster was set up in a well-lit environment, where the parents and staff had the opportunity to ask questions and provide comments. After the presentation, we assessed what the parents and staff had learned by giving them a quiz and comparing it with the one given before the presentation began. Doing this allows for an evaluation of exactly what the audience knew at the beginning of the presentation, and if their knowledge had increased by the end.

Objective 5

Utilize informational technology when managing individual and families in the community. Informational technology was used in the community setting in order to gain deeper insight into the population we would be serving. While working in the community confidentiality was maintained at all times to ensure that sensitive patient information was secure. Nursing informatics was also utilized when literature was distributed to the facility, with tips on ways that parents and staff could reduce stress in their lives, in order to promote health.

Objective 6

Demonstrate a commitment to professional development. While working in the community setting, research was conducted regularly for information on how we could best serve the population living in the area. The research was up to date and relevant to the issues the community is currently facing. When distributing literature to the staff and parents, the same guidelines applied. Though the semester is nearing its close, the issue of uncontrolled hypertension in children is a great one. I will continue to do research and formulate ways to reduce the occurrence of this disease by prevention, and treatment. This experience has made me look into myself and reflect on what more I could have accomplished during my time in the community. As I continue my career I know that challenges will arise, especially if I specialize in community nursing. I will have to face these challenges, and be prepared to practice independently which can be different from a traditional hospital setting.

Objective 7

Incorporate professional nursing standards and accountability into practice. While practicing in the community, the standards upheld by the American Nurses Association was and will continue to be used in my career. The ANA strives to promote safe and ethical work practice, that focuses on the wellbeing of the nurse, and advocacy for the public. I made sure to comply with the agency’s standard of practice by being respectful of their wishes, and following the guidelines outlined.  All of my actions in the clinical area were professional and respectful in order to keep clients and staff content and safe. The mission for First Steps NYC is the importance of early education, and family enrichment.

Objective 8

Collaborate with clients, significant support persons and members of the health care team. While interacting with the families in the community I made sure to involve the staff, in order to collaborate on ideas that would address client problems. Care was then coordinated based on the needs of the client and the interventions that needed to be implemented. During the time spent at the facility, literature was distributed containing resources for the client and the family. These resources including parenting classes, therapy, and GED classes to name a few. Information regarding local clinics and different insurance options were also available. These allowed for the families to make smarter choices, and take a more active stance when it comes to their well-being.

Objective 9

Recognize the impact of economic, political, social and demographic forces that affect the delivery of health care services. While working in the community that I was assigned, I realized that many families were not getting proper care due to the area they lived in. Resources in the area are few and far in between. In order for change to take place, individuals in the community have to take a stand and make sure that their voices are being heard. Families have to speak up, and take an active role when it comes to their own health, and the health of their families.

During my nursing school career, I was blessed with the opportunity to develop the skills and qualities needed to become successful and grow in my field. This course helped me to fine tune these skills, and better aid the public, with the goal of improving the quality of health care for all. The experience at the clinical site and in the classroom helped me to understand that community nursing is a field that is frequently looked over. Quality nurses are needed in this area for the purpose of preventing illness before it reaches a clinical level. Professor Egues did a great job in instructing her students on the various social, political, and economic factors that have an impact on the community, and how we as nurses can play a vital role in bringing about change in this area. My goal is to further my education, and carry what I have learned this semester with me.