Self-Reflection
Community health nursing was the first course that I had to take outside of acute care setting. In this course we were in to different community sites, where NYU Lutheran Medical Center provided health care services. Every Tuesday for 5 weeks we were in Salvation Army in 50th street between 5th and 65th avenue in Brooklyn. Every Wednesdays we were in “Our Lady of Refuge Church” located in East Flatbush. We checked BPs and BMIs and according to the results we thought healthy dietary choices along nutritional label readings and benefit of physical activities as well. As CHNs we used evidence based practice and adhere to ethical principles when delivering quality of care.
Objective 1: Demonstrates individual professionalism through personal behaviors and appearance.
Community health nurses like other health care professionals and represtatives should be in professional appearance. Individual appearance can influence interaction with other people and tell how professional one who is providing care is. We dress professionally in black suit pants and shirts. We wear our student IDs and have a pen with a board, BP machines and a scale. During the course of the clinical we were eager to learn and teach communities and individuals regarding healthy behaviors suck as healthy diet, importance of physical activities, hydration and regular checkup. All client information kept confidential.
Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.
We collected data by using CDC and NIH about the community that we served. I tried to discuss with individuals regarding their diet, physical activities and medication as well. Some of them
Did not understand and spoke, so I had to interpret it through visual aids, such as pictures and appropriate knowledge. I used accordingly for individuals by their first languages using flyers and handouts that were available in different languages. I used motivational interviews with therapeutic communication in order to build nurse- client relationship. I conducted interviews regarding cessation of tobacco use and limiting alcohol consumption. Also, explained the benefit to decrease sugar, cholesterol and sodium intake, and to increase fiber and protein consumption. No medication administration or treatment was implemented during the clinical, since it was in community setting and focused mainly health promotion strategies.
Objective 3: Effectively communicate with diverse groups and disciplines using a variety strategies regarding the health needs of individuals and families in the community setting.
Majority of population were French and Creole speaking some Spanish speaking people. Some of them could not communicate in English, so we asked their peers to translate. By using ethical principles and nursing standards and being culturally competent, respectful, I tried to deliver safe care through therapeutic communication that met developmental needs of the clients.
Objective 4: Establish environment conducive to learning and use a plan for learners based on evidence-based practice.
Since the community I served was diverse and had multilingual population, we provided, information in the different languages, such as French, Creole, Spanish, and Chinese. They were really appreciative. I used various kinds of flyers, handouts and printed visual aids in multiple languages to help them understand and recognize the information. The flyers and handouts contained information about heart disease and its cause, about diabetes, its sign and symptoms and prevention strategies, such as, healthy diet, physical activity, tobacco and other substance use cessation.
Objective 5: Utilize informational technology when managing individual and families in the community
We maintained client confidentiality by hiding personal information and heath records and not discussing in front of other individuals. I used electronic blood pressure machines to check BPs, it is quick and easy and very convenient. It keeps in memory the readings, so in case we missed the reading we can go back to machine and see the result. Also, I used BMI calculating app in the phone for accurate and quick results.
Objective 6. Demonstrate .a commitment to professional development
My point of view became broader regarding community health setting and how we can change the lifestyle of individuals and families. Since CHNs focus more on primary preventions, I learned how it is important to teach surrounding people regarding healthy lifestyle choices. So, in this way we can save lives and cost of health care delivery. I learned how I should continuously update my know kedge of current health care literature and evidenced based practices I can accomplish it by reading magazines and journal articles , becoming a member of American Nurses Association. It will help me to evaluate myself and my current knowledge of health care delivery.
Objective 7. Incorporate professional nursing standards and accountability into practice
When delivering care to individuals and families, I use American nurses association Standards and Practices to make sure the optimal level of care and client satisfaction. I adhere to agency standards of practices and I feel accountable for my actions in the clinical area. Respecting individuals, their beliefs, cultures, values, languages, background, ethnicity and race makes me to feel that I am culturally competent nurse. Being familiarize of the mission, vision and philosophy of the agency helps increase our roles, responsibilities and confidence makes me to engage in compassionate care. I also, try to engage in conversations and activities that builds trusting relationship between me and client. I try to deliver safe, optimal care which makes clients to feel that they are being cared of.
Objective 8. Collaborate with clients, significant support persons and members of the health care team
I use therapeutic communication skills with clients in the community. By being fully present through active listening and acknowledgement we show our caring and positive attitudes towards clients. That will make them feel that they are not alone and someone is here to take care of them and their families. After identifying their concerned and needs, I address them to the community nurse, who works with NYU Lutheran Medical Center to provide health services. During the screening process if I see very high results I notified nurse and our profession as well. And we tried to contact family members or relatives to notify them about health status of the clients. Once, the problem was that elderly woman did not had a phone and she could not remember and other family members phone numbers, so we basically could not reach and explain them that BP of their relative was really high and she needs to go to ED. Due to lack of insurances, most elderly could not afford to go to the doctors for regular checkup. So, we had to increase teaching about health promotion, so at least they can manage modifiable risk factors of the diseases.
Objective 9. Recognize the impact of economic, political, social and demographic forces that affect the delivery of health care services
In this community, majority of the individuals were of compliant with their medication regimen, due to diuretic effect, lack of insurance or just ignoring their health status. Languages barrier makes for them difficult to engage with health care provides. They ignore their overall health status and wait until last minute when disease process becomes sever. Some of them have insurances which requires additional co-payments for pharmacy and doctor`s visit, making them to ignore regular checkup and adhere to medication regimen. Because of this they may take their medications on time and skipping the doses or they might take once in two days, so in that way they will save more medications for the future or in emergency situations. Economic forces causes more losses and in turn negatively affects individuals.
In conclusion, I want to say that being among community and identify needs, promoting health through educating people can decrease morbidity and mortality rates. Increase knowledge of the community and access to various sources increases better health put comes through cost-effective quality health care. Delivering culturally competent, evidences based practices with compassionate care and enthusiastic way helps to build healthy community.
