Introduction

Before I began providing health care and education service at my community sites, I had expected that I will be communicating, educating, diagnosing, and constructing solutions to the diagnoses. I expected that I will be working in collaboration with peers and potentially other community health care students. My initial goals were to begin understanding the communities and any problems that the community members may have. In addition, I wanted to educate those members regarding their problems as well as other common problems within similar communities. Concerning diagnoses, I was expecting the possibility of some members experiencing psychological problems such as the use of alcohol and excessive smoking of cigarettes. My end goal was to create a change for the better concerning health and health education in the communities before I am to complete my student services. The following are nine objectives I have completed in order to achieve the goals of this course:

• Demonstrating individual professionalism through personal behaviors and appearance
• Employing analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting
• Effectively communicating with diverse groups and disciplines using a variety of strategies regarding the health needs of individual and families in the community setting
• Establishing an environment conductive to learning and use a plan for learners based on evidence-based practice
• Utilizing informational technology when managing individual and families in the community
• Demonstrating a commitment to professional development
• Incorporating professional nursing standards and accountability into practice
• Collaborating with clients, significant support persons, and members of the health care team
• Recognizing the impact of economic, political, social, and demographic forces that affect the delivery of health care services

Abstract

I demonstrate professionalism through my behavior and appearances in the clinical setting. I demonstrate and employ analytical and critical reasoning skills whenever I provide care to clients and their families. I aspire to provide effective communication to clients by understanding and relating with them not only in a professional and educational but also in a motivational and emotional fashion. These types of communication allow me to properly establish an environment that is conducive to both the learning and practical understanding for each client. A conducive environment provides comfort and satisfaction for each client; this allows me to build a trust and understanding with the clients and thereby allowing me to be capable of recognizing common situations and then their solutions. I apply all necessary standards within clinical practice, and I hold myself accountable for all actions committed or concerning by me. I understand the significance of collaboration very well as a result of first-hand experience that I have gained with my peers within the clinical community.

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

In my opinion, I maintain confidentiality with clients and their family members in a very professional manner. Each client has their right to privacy. I have been strongly influenced and taught to maintain their right to privacy with outmost effort. Efficiently reporting and analyzing patient safety events help lead myself toward being more capable of properly applying HIPAA rules and regulations. For each clinical group, I was able to prepare learning materials for the clients concerning nutrition and diet, BMIs, risk factors and prevention of high blood pressure, hydration during hot weather, and exercising. All assignments are completed and given or posted in a timely manner. Whenever I require guidance, I search for assistance and ask questions to my professor and my peers; in addition, I may explore online for answers or solutions. I attend each clinical pre and post conference. I participate in these conferences by being attentive and actively engaged during any given questions or explained answers. If I cannot absolutely comprehend a certain topic being mentioned during a conference, I follow up by researching and refreshing my knowledge regarding that topic. I believe that I maintain good accordance with school policy and clinical punctuality. I aim toward being as honest, punctual, professional, and ethical as possible concerning all of the school and clinical settings which I am in. Professional attire is crucial and thereby I always maintain to dress in a professional manner by wearing casual yet professional attire. I exclude from wearing any form of clothes that are overly casual or inadequate and deemed inappropriate.

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

  Utilizing client interview, nursing and medical records, staff nurses, and other health professionals to collect client information is difficult in my situation as a student studying communities because many clients from these communities do not have medical records and other similar information. However, I do utilize any client interview and professional help when possible considering the situation and circumstances. I believe that I assess the impact of developmental, emotional, cultural, religious and spiritual influences on the client’s health status, and I think that I sometimes do so subconsciously. Providing care for clients is an objective that I carry out by determining and evaluating not only a client’s clinical condition but as well their psychological conditions, which may concern his or her culture and religion. During times when I have taken a client’s blood pressure or height and weight, I attempted to collect relevant information to the client’s self-care needs. Based on my analysis of the client’s medical history, I have tried to prioritize their need by implementing safe and certain care and nursing interventions in a timely manner. At the particular clinical settings where I am, I am not responsible for administrating medication or treatments, but I am responsible in educating clients regarding safe use of medication. I evaluate two different groups based on weekly monitoring of their blood pressure screening, ability to verbalize low-sodium diet, appropriate nutritional and daily water intake. Outcomes of certain clients are met, but others require modification of the given timeframe. I believe that I am providing and maintaining a safe environment for the clients within the community by becoming familiar with the surroundings such as knowing the location of the closest exits and being able to work with the allowed scope of practice as a student nurse.

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.

Nursing is a caring profession, and therefore I utilize therapeutic communication with individual clients based on their unique needs for certain care and education. In the settings where I am expanding my knowledge, I mostly use face-to-face interaction that focus on advancing the physical and emotional well-being of a client. My purposes are mainly designed to collect information, determine illness, assess and modify behavior, and provide health education. My communication with instructors and peers concerning significant data is very productive and clear because we are all skilled practitioners. I adapt my communication skills by being courteous, understanding, and having non-judgmental attitude towards my clients. The only written documentation that I am able to obtain concerns general and anonymous health surveys, blood pressure screening, and BMIs.

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

I implement education with my clinical group to clients and their families based the nursing plan. Every time that we were able to provide presentations concerning various health subjects such as nutrition and staying hydrated during hot weather. Based on the unique environment among each community, I was able to use certain factors that I believed would been advantageous such as using body language with non-English speaking clients and being able to provide brochures that were written in the client’s native language. Based on the clients and families that were able to verbalize or demonstrate in return the information provided during the presentations, I was able to evaluate their learning outcomes.

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

I was not requires to utilize principles of nursing informatics in the clinical area because I obtain relatively little amount of data and information that would be considered necessary to process into a computer. However, any records and information that I do obtain from clients are subject to strict confidentiality.

Objective 6: Demonstrates a commitment to professional development.

I try to use the most appropriate and up-to-date literature when planning care for clients in the community setting. Presentations and communication provided to clients are built on such literature. I enjoy assuming responsibility for lifelong learning, especially when it concerns clinical education and practical engagement of that which I have learned. I engage in self-evaluation on a daily basis because it helps me recognize and improve my strengths and weaknesses toward my next clinical session. I believe that honest self-evaluation is very important. Self-evaluations help me to grow not only as a person but also as a professional in different community settings. I try to commit myself toward adjusting to the challenges of independent practice in community health nursing by not only recognizing but by also being sensitive toward cultural diversity as a non-Hispanic and non-Haitian speaking person.

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

I utilize American Nurses Association Standards as well as the agency’s standards in clinical practice by providing excellent ethics, standards, practices, and by creating a healthy and non-judgmental environment considering that there is a large population of homeless men and women who attend soup kitchen at Salvation Army. As a professional, at any given time I am accountable for my actions in the clinical area. I recognize each action that I commit and my responsibility concerning the lives of other people. I am aware of the assigned mission by my agency for the Salvation Army, which is to motivate and aid human needs without discrimination. I am also aware of the assigned mission by my agency for Our Lady of Refuge Church, which after the Great Depression began its mission on focusing more on service to the community and providing aid to those in need.

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

I collaborate effectively with active health care groups who address and help solve client problems. Collaboration is important because it provides each member with unique knowledge and experience given by all the collaborating members. A great example of collaboration is when my peer and I had to provide presentations, which she performed in Spanish and I performed in English. Another good example that I recognized was when one person was measuring the weight and height of a client and another peer was calculating their BMIs. Each member within a collaboration team was able to contribute toward teaching of clients and family members based on our different nursing backgrounds, cultural backgrounds, and age group as well as gender. Once a month, in Our Lady of Refuge Church, there is a person who is able to assist with establishing medical insurance clients in need. Volunteers are able to provide information of local clinics and services within the area.

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

I have recognized that some communities have a great number of challenges compared to other communities based on economic, political, social, and demographic influences. In both communities, which were Spanish, Asian, and Haitian, some of the primary struggles were the language barrier, lack of insurance and knowledge. Once I have been able to recognize these issues, I understood that educating, setting realistic goals, and providing emotional support. I believe that advocating for clients to change their daily habits concerning nutrition and personal health will provide only positive results to both the clients and their families.

Summery

Many of my expectations that I have mentioned in my introduction did happen. I now understand the communities and their members at both Our Lady of Refuge Church and Salvation Army. I analyzed their diagnoses and recognized both the issues and solutions to those issues. Many of these were as I had expected; poor nutrition, poor hydration during hot weather, lack of exercise, and lack of general knowledge concerning personal health. However, I also recognized a few other issues such as lack of motivation to continue living a healthy lifestyle, and language barriers between the community health care nursing students and the members of those communities. By recognizing these problems, collaborating with peers, and being organized and informative, the language barrier no longer posed a threat to our goals. I am hoping that our continuous education and communication with the community members will improve their motivation. On the bright side, I noticed very little use of alcohol as well as excessive smoking of cigarettes, which makes me happy. Overall, I have really enjoyed my experience at both communities. The feeling of helping these people in a way that can impact the rest of their life for the better pleased me a lot.