Introduction: My clinical site for Community Health Nursing was the Head Start Cypress Hills office, which is located at 3295 Fulton Street, Brooklyn, N.Y. This particular clinical site provided government and donation funded daycare services for low-income families that lived in the area. Nurses often focus on the opportunities that are available to them within a hospital or acute care setting. However, this course emphasized the many roles that registered nurses have within the community, and how we could make a difference in the targeted population through research and implementation. My experience in this course has been rewarding and enlightening. I have discovered a vast amount of opportunities that are available to me in the community setting, and will forever treasure my experience with the amazing children at the daycare center.
Objective 1: Demonstrates individual professionalism through personal behaviors and appearance.
One of the activities that we participated in at the Head Start clinical site was reviewing the children’s charts to make sure that all of their healthcare information was up to date. I made sure that the information within the chart was not discussed outside of the Head Start setting, and that it was not discussed with anyone who did not have access to the chart. I protected the confidentiality of the clients, and maintained HIPAA policies as well as NYCCT policies. Our clinical professor always followed the syllabus in preparing her pre and post conference sessions. Therefore, I would review the material that would be covered for the week prior to going to clinical. I would ask questions and seek clarification on matters that I did not understand properly. My clinical group ad I gave five presentations to the children in the daycare center, and one presentation to their parents for our service learning assignment. We chose to separate the group into two smaller subgroups so that each group had a substantial amount of time to plan their presentations. Both groups wee assigned a group leader-who initiated communication and delegated responsibilities. A recorder was also appointed in order to keep all of the ideas organized and well documented. Over the course of the semester, I made sure that I dressed professionally and arrived to my clinical site on time.
Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.
Analytical reasoning and critical thinking skills are essential components that every nurse must have to provide the best quality of care. The Head Start clinical site was not a typical healthcare setting-which meant that I did not get to physically see patients or administer medication. However, the needs of the population that my group was catering to were assessed so that we could provide teaching and education based on the needs of the community. While conducting the Windshield Survey assignment, my classmates and I noted barriers and issues that affected the health and wellness of the community. We always made sure to travel in groups of no less than two individuals to ensure safety while collecting data about the neighborhood. We ultimately chose to present the topics of nutrition, exercise, dental hygiene, food allergies, and influenza/infection control to the children-as these are important topics that are currently affecting the pediatric population. In presenting these topics, the information was prioritized based on what we felt were the most important concepts for the children to learn. Additionally, information about Epipen use and influenza vaccinations was provided to the parents of the children during the adult presentation that was given. After each teaching session, we evaluated the level of understanding by asking post questions. The children’s interest and understanding of the concept was always observed to determine if any methods of teaching should be adjusted or changed for the next presentation.
Objective 3: Effectively communicate with diverse group and disciplines using a variety of strategies regarding health needs of individuals an families in the community setting.
Many communities in New York City consist of diverse groups of people that belong to a myriad of different cultures and religious groups. Culturally component care is an important factor in rendering the best possible outcome in client satisfaction. The majority of the children at the Head Start clinical site were Hispanic. In the beginning of the semester, my clinical professor identified all of the individuals in our group that were able to speak Spanish. Three of my classmates fluently spoke and understand the language, while I speak and speak and understand an intermediate level of Spanish. We made sure that we communicated in both English and Spanish for the presentations, as well as when we communicated our needs to the daycare staff whom also primarily spoke Spanish. In addition, we incorporated material that was unique to the Hispanic culture in our presentations. In example, we included Hispanic food props, such as tacos, in our nutrition presentation. Furthermore, our clinical group had to communicate very simply and interactively with the children. It was very humbling to explain complex topics in the simplest of forms. I believe that this was a great reminder of the fact that developmental and educational level should always be assessed in every client so that information can be relayed effectively.
Objective 4: Establish environment conductive to learning and use a plan for learners based on evidence-based practice.
The final presentation that my clinical group presented for our service-learning project was to the parents of the children at the Head Start daycare program. We used Microsoft PowerPoint to convey the information. The information was procured from reliable government websites and evidence-based studies that were featured in academic journal articles. We presented the material in English and Spanish. We utilized the translation services of our clinical professor and the program director for medical terminology translation that perplexed us. We asked the parents post presentation questions to evaluate their learning. I noted that they were able to answer the majority of the questions. Questions that were answered incorrectly were clarified and further teaching and reinforcement were provided.
Objective 5: Utilize informational technology when managing individual and families in the community.
Nursing informatics integrates the use of technology in providing knowledge and information regarding the promotion of health and wellness to the public. My clinical group and I used the computer to show the children informative videos pertaining to their health. Furthermore, we also used an ipad and speakers to play music for the children. I believe that this was the best way to gain the attention of the children because they needed interactive learning tools that would stimulate their interest. We used a PowerPoint presentation for the parent presentation because we felt they would benefit from seeing evidence-based information. It showed that we had credible data that they could rely on in seeking healthcare for their children and families.
Objective 6: Demonstrate a commitment to professional development.
I was able to identify the importance of professional development during the time spent at my clinical site. We had to research lots of information in order to determine the most effective way of transmitting information to the pediatric population, as well as providing them with evidence-based knowledge. If we noticed that the children were losing interest or did not understand the material because it was too complex, we would brainstorm our thoughts and ideas and make modifications to our upcoming presentations. It was challenging to present to the youngest group of children because they often lost concentration. However, additional research was conducted on how to best reach their cognitive understanding.
Objective 7: Incorporate professional nursing standards and accountability into practice.
The American Nurses Association sets the precedent for nursing practice across our nation. I complied with all of NYCCT’s standards of practice by behaving in a professional manner and complying with the clinical standards for practice that the American Nurse’s Association adheres to. I exercised accountability by practicing ethically, maintaining confidentiality, and advocating. I also complied with the standards of the Head Start daycare center. My clinical group and I were given information on the policies and mission of the Head Start program on the first day of our clinical. The director requested that the presentations be no more than fifteen to twenty minutes long for each class since the children lose attention very quickly. Therefore, we made our presentations within the time frame that the director requested.
Objective 8: Collaborate with clients, significant support persons and members of the health care team.
I effectively collaborated with the team members of the Head Start daycare program to address problems that were affecting the children. They approved the topics that were chosen and agreed that they were important. The staff members at Head Start provided us with helpful suggestions regarding effective ways that the clinical group could teach the children. I was very appreciative for their recommendations. We did not coordinate client care at my clinical site. However, we did provide information and health care resources to the parents that attended the adult presentation. This includes places where they could get their children tested for allergies at an affordable price, where allergy bracelets could be purchased, healthcare offices in the community and different locations that offered the flu shot for free. We encouraged the children to make healthy choices during our presentations to them, and provided activities that would help to guide them. In example, we gave them an assortment of toy food items to choose from, and asked them to prepare a plate of food based on what we had taught them. The children were able to make healthy choices based on what was taught to them. If wrong choices were made, we explained why the choice was incorrect and supportively encouraged them to make another choice.
Objective 9: Recognize the impact of economic, political, social, and demographic forces that affect the delivery of health care services.
While the United States provides great healthcare, there are gaps that have been identified in the care system. In assessing the neighborhood in which my clinical site was located, I found that the two nearest hospitals are approximately twenty minutes away by car. If a community resident relied on public transportation, this commute time would increase. Sadly, this finding means that people would be less willing to seek care at one of these hospitals if it takes them a long time to get there. Furthermore, there were very few clinics in the community. Together with the two major hospitals being a far distance away, this implied that healthcare services were not very accessible. Another issue that was identified was the lack of fresh food markets and grocery stores. Many of the food stores were cultural in nature or fast food establishments. Stores that did offer fresh foods sold these items at a higher price. This would discourage the public from buying the food items, and contribute to nutritional disparities. My clinical group and I reached out to the director of the Head Start program regarding any health and wellness programs that were taking place in the community. He told us that a health fair would be held in the neighborhood in June, and encouraged us all to attend and possibly set up a table representing NYCCT. We would be able to provide the public with information and provide advocacy for appropriate healthcare.
Conclusion: Community nursing is an extremely rewarding and unique field of nursing. It is fueled by research and one’s ability to reach a particular population effectively. Before taking this class, I believed that community health only referred to homecare nursing, clinics, and private practices. However, I now understand that there are many opportunities and fields that are incorporated into community nursing. I had an incredible experience at the Head Start clinical site, and look forward to developing professionally and exploring all that nursing has to offer.
