Self-Reflection Narrative
Objective 1: Demonstrates individual professionalism through personal behaviors and appearance.
Confidentiality is an essential part of nurse-client relationship. The clients were assured that the information they revealed to nursing students would not be divulged to other people. The clients âpersonal information, including home address, health status, telephone, and date of birth were kept out of reach from other people. The sign-in sheet was kept by the nursing studentsâ sight to avoid exposing personal information to the public. The conversations pertaining to the clientsâ health status were discussed discretely to maintain clientsâ confidentiality. Although I worked in collaboration with my classmates, I sought out assistance from my professor, and the food pantry volunteers to ensure that services were rendered as expected. Prior to each clinical session, I collected information pertaining to the community needs, and for my own intellectual development. I completed my assignments in a timely manner and actively participated in all clinical discussions. I was punctual in accordance with the schoolâs policy. I dressed appropriately for each clinical session, wore my school ID badge in compliance with my schoolâs policy, and treated clients with respect and dignity.
Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.
The collection of personal information is an important aspect of nursing practice, and proper communication skills are needed. In the clinical setting, the clients were interviewed in private to collect information pertaining to their health. The clientsâ emotional, cultural, religious, and spiritual practices were integrated in the care. The majority of clients were not resilient to the Western medicine, and relied strongly on cultural, religious, and spiritual practices. A psychosocial assessment was conducted briefly to assess living conditions, available resources, and daily expenses. A complete physical assessment was not feasible at this site, but the clientsâ blood pressure, height, and weight were assessed in depth. When a blood pressure reading was out of range, the client was encouraged to seek medical help as soon as possible. If the client denied intervention, the clinical instructor would intervene to encourage the client to seek medical care. I noted that sometimes it is better to be frank with the clients, and tell them that if medical assistance is not sought in a timely manner, they will eventually die. The clinical did not involve administration of medications or treatments. However, during blood pressure readings, and Body Mass Index (BMI) calculation, patient safety was a priority. The standard for blood pressure cuff placement and proper BMI techniques was utilized to get accurate results. The nursing process was utilized to determine whether or not the initial goals were achieved as expected.
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.
The population was very diverse, but the people who attended the food pantry were mostly Haitians. The Haitians spoke French, Creole, and limited English. It was a challenge to assess their needs, and concerns due to their language barrier. In my capacity as a nursing student, I attempted to learn a few Creole words, such as blood pressure for free, how old are you, thank you, and welcome. The clients appreciated my input, and rewarded me with proper Creole pronunciation. The communication techniques used were, silence, accepting, and offering self. The clients were spoken to at an eye level, and body language was also taken into consideration to avoid offensive mannerisms. Some clients were receptive towards the communication techniques, but others thought it was a waste of time. The clients that spoke English and Creole preferred to speak English. They felt offended when they were asked about their primary language, Creole. As a side note, nurses need to assess each clientâs literacy level to avoid misinterpretation of clientsâ overall knowledge. The instructor was involved in all discussions, and an intervention was implemented when necessary. I asked my classmates for feedback and support to better service the community.
Objective 4: Establish environment conducive to learning and use a plan for learners based on evidence-based practice.
Evidence-based practice is the best practice that has been proven and validated through research. It has an emphasis on setting priorities in nursing practice, allowing nurses to provide the best nursing care. Every interaction with each individual client was in accordance with the Nurse Practice Act (NPA) regulations and standards. Every effort was made to establish an environment conducive to learning. The clinical was held inside Our Lady of Refuge Church, and the food pantry was arranged by the nave area, and the nursing studentsâ desks were situated near the sanctuary. The distance between the food pantry, and the nursing studentsâ desk made the environment conducive to learning. The clients were not interrupted or disturbed during blood pressure screening and teaching. The environment made it possible to build rapport with the clients based on evidence-based research and practice.
The clients were encouraged to participate in blood pressure screening, BMI calculations, and to discuss eating habits. Food items such as Goya beans were placed at the nursing studentsâ desks to encourage clients to read nutritional labels. The nursing students assisted each client to read the nutritional labels and to identify the nutrients and calories in one serving of food. The clients were encouraged to rinse the Goya beans several times minimize the sodium content. Many clients were able to provide a return demonstration, but others were not resilient. Others did not understand the concept behind rinsing the beans, and as a result they became irritable. It is cogent for nurses to recognize clientsâ literacy level to improvise appropriately for continuum of care.
Objective 5: Utilize informational technology when managing individuals and families in the community.
The clinical was held at Our Lady of Refuge Church, and the nursing students had no access to computers or clientsâ personal records. Although there was no access to computers or clientsâ personal records, I adhered to the standards and regulations of confidentiality. I discussed clientsâ concerns discreetly and in private, to avoid divulging personal information. The signing sheet was monitored by all nursing students to protect the clientsâ personal information. The blood pressure readings were not exposed to other participants. When some of the clientsâ blood pressure readings were extremely out of range, I kept my composure to avoid alerting others. A nurse is responsible to maintain clientsâ confidentiality at all times regardless of the circumstances.
Objective 6: Demonstrate a commitment to professional development.
Evidence-based practice is an important aspect in nursing practice, and it contributes to professional development. In addition, professional development can be achieved by reviewing nursing journals, Cumulative Index to Nursing and Allied Health Literature (CINAHL) database, and other resources devoted to the field of nursing. The nursing process is essential to nursing practice, and its emphasis on setting realistic goals attributes to realistic outcomes. The nursing profession is a lifelong learning journey, and it includes enlightening the clientsâ life by promoting health and wellness. The nursing profession encompasses many challenges such as independent decision making, managing clientsâ health, and understanding clientsâ demands. In the clinical site, language barrier was particularly a concern, but a Creole-speaking classmate took the stance and served as a translator. A Community Health Nurse needs to improvise to adjust to the challenges that are faced in order to serve the community at its best. I want to dedicate myself to serve children living with HIV/AIDS, and to travel overseas to provide individualized care to children infected with the virus. My goal is to obtain my Masters in Nurse Anesthetics, and to provide individualized and specialized care to the HIV population.
Objective 7: Incorporate professional nursing standards and accountability into practice.
The American Nurse Association (ANA) is definitely a great resource that nurses can rely on to keep up to date with current nursing literature. Throughout my clinical rotation, I adhered to the ANA regulations and standards. I worked in collaboration with the food pantry volunteers, and Lutheran Medical Center personnel to promote safety, and high quality care. I reviewed and complied with the standards of practice of Lutheran Medical Center, and acted in accordance with Our Lady of Refuge Church rules and policies. I was accountable for my actions in the clinical area, for example: ensuring client safety, privacy and confidentiality, consent prior to service, being culturally competent, and respecting clientsâ decisions. The objective of Our Lady of Refuge Church, Lutheran Medical Center, and the Food Bank for New York City is to provide food for the underserved population, and to put an end to starvation in the community.
Objective 8: Collaborate with clients, significant support persons and members of the health care team.
A successful nurse has the ability to communicate effectively, and possess the skills to address clientsâ problems appropriately. The clients concerns and problems were discussed collaboratively as a group. Group discussions were held in every clinical, and previous learned knowledge was applied to address clientsâ problems. I sought out assistance from my classmates, professor, and Lutheran Medical Center coordinator to ensure continuum of care. The nursing students in collaboration with Lutheran Medical Center provided information about free mammograms, low-cost medical insurance, and linked clients to other resources in the community. The clients were taught to read nutritional labels, and to identify vital nutrients to promote heathy eating. I encouraged the clients to rinse the Goya beans to remove excess salt content. The clients were willing to make lifestyle changes such as including more vegetables and fruits in their diet. The clients were in agreement with incorporating an exercise regimen to maintain an appropriate weight. Although the clients had difficulty with articulating their thoughts, they verbalized understanding to making appropriate lifestyle changes.
Objective 9: Recognize the impact of economic, political, social and demographic forces that affect the delivery of health care services.
The experience enriched my knowledge to the gaps in the healthcare system. There is a high percentage of uninsured and undocumented people in the community, as a result, the number of mortality continues to rise. A Community Health Nurse (CHN) can develop a modification plan by utilizing the nursing process. The plan would include identifying the specific problems, and finding the necessary solutions to achieve potential outcomes. First, education is essential in preparing clients to advocate for themselves and to seek assistance without fear. The majority of undocumented people do not seek assistance due to fear. They often feel powerless and unable to advocate for themselves. Secondly, a CHN requires commitment, dedication, and the strengths to advocate for what is right. Third, knowledge is power and working in collaboration with other healthcare providers can bring changes to the community. The language barrier in the community is the primary contributor to the lack of clientsâ knowledge and awareness. I would definitely outreach to Creole-speaking nurses, social workers, and other professionals to better serve the community. I decided to embark the nursing profession to enlighten, and positively impact every individual at the bedside or in the community. The value of nursing is not only by the bedside, but the nurse within.
