Self Reflection of Clinical Experience in Community Nursing

Community nursing has really broadened my view of working with diverse families, groups and providers to address complex challenge in community setting.   My professional nursing skills have also been enhanced by practicing the following nine objectives through community clinical training.

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

There was five weeks clinical training provided for the students of community health nursing in a senior center of Manhattan.  Every Wednesday morning, I prepared myself with nutritious breakfast, requested nursing stuffs like BP cuff, stethoscope, note pad, business casual dress and a pair of comfortable shoes, and then I attended the clinic punctually and in accordance with school policy. During preconference, professor had discussed the upcoming events in the senior center, and rotated us to engage into different activities and services. I really enjoyed interacting with these seniors, and conducted a continued health teaching through health screening, exercising and communicating under a relaxed and pleasurable atmosphere. However, asking for permission and providing them with privacy had always been followed prior to every interaction.  I have also completed all assignments and the group project with my peers under the guidance of school syllabus.

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

Unlike hospital setting the patient is the center source of data collection, in community there are many factors could impact residents’ health and have to be considered by community nurse. We collected data through a windshield survey initially to get know about this neighborhood, background of residents, cultural, environmental, economic and social status, then focused on the seniors who participated in the senior center. Through conducted health screening about their blood pressure, discussed about their medical and medication issues, to identify the needs for their self-care. Then we planned a teaching topic accordingly to help improve senior’s awareness of the importance of keeping a normal blood pressure and the strategies of how to help achieving the goals safely.

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.

Good communication is the essential for the successful outcome of individual nursing care of each patient. I have communicated with each senior in the center in a therapeutically way, such as using the short and clear sentences for their health screening, then given them enough time to processing the message then answering on their own speed.  I utilized the techniques of repeating and clarify if there was confusion for seniors. Listening is also an important type of effective communication. Especially interacted with the seniors who lived alone, offered my ears and closed attention to their story, concern or just nagging could make them feel more comfortable. Once found out someone’s SBP was out of range of 160, I had reported to instructor and center stuffs promptly, and attached with documented assessment.

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

We provided a health fair presentation on hypertension prevention to all seniors in the center toward to the end of clinical training. The posters and brochures containing health information distributed to all seniors. A pre test and a post test offered throughout personal presentation to help evaluate how effective the teaching would be.  We had also used giving away prizes for correct answers to motivate seniors to  engage into this learning opportunity and able to learn in a pleasure environment.

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

From preparing my assignments and our teaching plan, I have utilized the computer quite often, went through a lot of online research, and referenced from many of reliable nursing or other authorized resources.   This senior center even opened their computer lab to us for a prompt onsite online searching. For seniors’ private information such as name, BP reading, medical history and any personal matters, I have treated very cautiously and confidentially.

Objective6. Demonstrate a commitment to professional development.

I have committed myself into this professional development from getting familiar to the community setting and the duties of community nursing prior to this clinical study, completed all request assignments and worked with seniors with variety of culture backgrounds, I had evaluated my own belief and cultural background prior to interact with them, in order to offer a more appropriate and effective teaching plan to improve their health awareness.

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

I had followed strictly according to American Nurses Association Standard, by utilized the nursing process of assessment, diagnosis, planning, implementing and evaluation to set up our teaching plan for the seniors to address their needs. I also practiced within my scope of practicing and delivered my care in the manners of protects senior’s autonomy, rights, values and beliefs.  My practices and behaviors were conducted properly and in accordance with the senior center’ rules. I also highly respect the center’s mission “cultivate friendly relations among the members of the Stein Senior Center and the general public; the provide services with an emphasis on group growth; to share the strengths, and wisdom of senior citizens; and referral services, and to safeguard the health and wellness of senior citizens”.

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

The stuff members of senior center are very kindly and supportive. They provided a private room for our group conference and also used for blood pressure checking for the seniors privately. They also provided us with center’s information and free-entry to computer lab to support our research in preparing the health teaching.  Through individual or group interaction with seniors, I highly encouraged them to adopt a healthy lifestyle to prevent or slow down the process of developing a disease. And I also offered them with some healthy information to follow or recommended a follow up with their primary providers or local health facilities if their condition seemed necessary.

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

A person’s health is always impacted by many factors: social, political, economic and environmental status. Thus, one’s social status could determine his or her health condition, or the accessibility to health care service or to healthy lifestyle.  As in this center of Manhattan, many of seniors complained that they have trouble to shop for affordable and fresh food in this area due to the limited food markets with high price. Therefore, unable to access healthy food already put many seniors’ health in great jeopardy. And hypertension, diabetes, and cardiac issues already become prevalent in this area. As a community nurse, I felt that I am obligated to advocate for these clients for seeking a change and improvement in their environmental condition through local policies and organizations.

I am appreciated for having this clinical opportunity to be exposed to the community and interact with seniors as a nurse. Which I think is very rewarding and challenging. Clinical experience is broadened my view of community’s health impacted by many factors, and the role of community nurse is to fight with them in order to improve the community health.