Introduction
Community Health Nursing offered me the opportunity to see nursing in a different view. A broad view that is complicated, yet interesting and needs immediate interventions. The problems noted were primarily closely related to the disparity in health care provided to various communities, that resulted in extreme differences in their outcomes. But in order to address the disparity and complexities of these issues, first, I have to acknowledge the underline cause of these problems. Listed below are tools (objectives) to assist me in identifying the problems and then seeking appropriate remedies to address those issues.
Objective 1: Demonstrates individual professionalism through personal behaviors and appearance.
Throughout every clinical, as a professional, I maintained confidentiality with every community member I had interacted with. I assume the responsibility for my own learning by keeping up to date with the assigned reading materials from lectures and incorporating it into my clinical settings. I prepared for every clinical with the necessary instruments to render an adequate health assessment for the community members. All assignments were completed in a timely manner, on or prior to the due date. When I was in need of help during certain tasks, I had sought guidance appropriately by always asking respectfully and courteously. I participated in all clinical conferences by actively listening to others and contributing by responding when appropriate. I arrived to every clinical punctually, cleaned shaven, well groomed, and dressed in proper attire to show my respect for the facility, its members, my instructor, fellow classmates, the organization I represented and most of all, for myself.
Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.
Information collected from the senior community members were obtained by direct interviews and the continuous open communication with the staff members. I was able to assess the impact of developmental, emotional, cultural religious and spiritual influences on the members’ health status through interviews and casual conversations. Significant data relevant to members’ self-care needs were collected through interviews and instruments such as my blood pressure cuff, stethoscope, etc. Selected members’ physical assessments were completed by working in partnership with the members. Most assessments performed at the community center were visual, and via interviews. Health concerns that arose from elevated blood-pressure readings, were immediately addressed. Members were strongly urged to seek emergency help at the local hospitals or see their primary care provider as soon as possible. Care was prioritized based on the level of health issues at the community center. With the exception of several individuals for the elevated blood pressure, most of the members were active and relatively healthy. The outcome is that they would not have elevated systolic blood pressure more than, 160 mmHg and/or a diastolic blood pressure more than 90 mmHg for the next 7 days. Although, they were mostly stable members, some were not aware that they need to see their primary care providers to adjust their blood-pressure medications. Utilizing principles of personal safety when working in the community setting, entails hand hygiene, clean up any spillage immediately, and remove any other potentially dangerous objects that may cause a fall or injury.
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 settings.
Therapeutic communication was exercised in the community with the members during all conversations. I sat on the side of members’ during all discussions instead of directly in front of them. I sat up straight up and maintained eye contact at all times. I spoke clearly at a normal pace without being too loud. I utilized humor and also kept a smile most of the time to promote comfort. In addition to the community members, I had communicated clearly and effectively with my instructors, classmates, and staff members by displaying respect and professionalism towards them. Furthermore, I had adopted communication skills to the developmental needs of the clients by utilizing active listening and giving the members ample time to respond to any questions. Reports, documents, assessments and nursing interventions, were accurately posted by means of a private blog so that peers and my professor can share my experiences.
Objective 4: Establish environment conducive to learning and use a plan for learners based on evidence-based practice.
The teachings rendered in my community site were during discussions of their blood pressure screenings and exercise sessions, which were auditory, visual, and kinesthetic. It was rendered in well-lit rooms, such as the activity room or in front of the cafeteria. By performing the exercise routines in front of the community members, they were able to see and follow our movements. Their ability to mimic our movements, displayed that the learning was successful. Furthermore, my group and I are in the midst of establishing a group project that will be presented with the use of PowerPoint slides. After the presentation, I will evaluate the outcome of the learning by speaking to the members randomly during casual conversations.
Objective 5: Utilize informational technology when managing individual and families in the community.
Informatic-nursing technology was not available and/or applicable at this time in the senior center. Although there are no direct electronic medical records used at the community center, members may access their medical records through the onsite computers. For example, they can log on to “MyChart at NYU Langone” or “patientfusion.net”. Strict confidentiality is always maintained with the exception of sharing information with interdisciplinary team members with direct involvement in the member’s care.
Objective 6: Demonstrate a commitment to professional development
To ensure the information given to the members was accurate and up-to-date, obtaining appropriate current literature in planning care for the client was imperative. Information had to be from credible resources and evidence-based. Literature obtained were either result of systematic reviews or meta-analysis. It is my duty to continue my lifelong learning by incorporating all of my clinical experiences, clients’ concerns, and information acquired from scientific literature and/or teachings. In addition, I will continue to evaluate my own personal commitment to the nursing profession by my support to the clients, their concerns, their beliefs, their culture and their overall health. Furthermore, I will commit myself to accept the challenges of independent practice by utilizing all available resources and advocating for the clients, whether it is one patient or the entire community.
Objective 7: Incorporate professional nursing standards and accountability into practice.
As a member of the American Nurses Association (ANA) and a Registered Nurse (RN), I upheld the nonnegotiable code of ethics imposed by my profession. My obligation is always to uphold and adhere to this code of ethics, so that my care during my clinical meetings, were always centered towards the senior members’ overall health. I was able to provide the care to the members in compliance with the agency’s standard of practice while taking responsibilities of all my actions. My efforts were geared toward the agency’s mission to promote/protect the senior citizens’ overall health and wellness.
Objective 8: Collaborate with clients, significant support persons and members of the health care team
Open communication was continuous with my professor, peers, staff members, and volunteers at the clinical facility to address any issues and provide any interventions deemed necessary. The members’ needs and therapeutic interventions were coordinated prior to lunch time. Blood pressure screenings were conducted prior to eating to ensure accuracy and exercise activities were rendered prior to meals to avoid promotion of digestive discomfort. Health care resources identified for the members are incorporated into our holistic health fair will be held on May 13, 2015. Face-to-face invitations, telephone calls, emails, and other methods were utilized to acquire resources to this fair. Professional and experts obtained, helped me and my peers guide the members to make appropriate lifestyles and treatment choices. In the process, members were also connected to the appropriate community agencies to satisfy their overall needs.
Objective 9: Recognize the impact of economic, political, social and demographic forces that affect the delivery of health care services.
I realized the gap in our health care system was the disparity of care provided to our communities. Evidence from various resources indicates economic, political, social, demographical, ethical, cultural, age, gender, sexual preferences, and other factors has an effect on the care received and the differences in outcome among various clients. In order to rectify this ongoing problem, I have to identify all areas of the issue including the complexities and then seek available appropriate health care remedies for the clients.
Conclusion
Initially, I had the misconception that a Community Health Nursing course was similar to a speech class; where we would read a research articles and present it in front of clients during each clinical session. I didn’t realize how involved and complex our communities are and how desperately in need of better health care. Today, I am fortunate enough to have been introduced to the various methods to participate in advocating for the clients. In developing this knowledge, I understand that I can make a difference in their lives. A difference that I cannot accomplish alone, but with the ability to seek appropriate help from others, I can see someday that disparity will be a thing of the past.
