Community Nursing

Narrative Self-Reflection

Introduction:

During this last semester, I have been pushed to use all the clinical assessment and implementation skills that I have accrued during my education. This semester my vision was pushed past the patient and into the community. I was given the opportunity to be in a position where my nursing skills were used to cater to the community as a whole rather than one individual at a time. This semester my clinical setting was at Kings County Hospital in Brooklyn, NY. I took a glimpse into the activities that occur in the outpatient clinics. My experiences took place in the diabetes and OBGYN clinics. My encounters were insightful because I witnessed the day-to-day issues that arise in these areas and was learned how community health nursing is able address these issues.

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

Professionalism is vital in all aspects of client care. Client confidentiality being one aspect of professionalism that has a role in client care. During my experiences at Kings County Hospital, I was given access to client information. I ensured client confidentiality was maintained during my entire clinical rotation. I only discussed client information during clinical conference at which point clients were only identified by their initials. Professionalism also entails being responsible for individual learning. There a few individual online learning assignments that were assigned. I assured that I completed these assignments in a timely manner and submitted them through the proper channels. I made sure that when there were situations where I did not understand what was expected of me I contacted my clinical professor for clarification and guidance. Throughout the semester, I made it my duty to arrive to clinical in a timely fashion while wearing the proper attire.

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

Knowing when and how to apply analytical reasoning and critical thinking skills are vital to delivering adequate care to clients, especially in community setting. Unfortunately, this semester I was unable to employ these skills in my clinical rotation. I employed these skills in the planning and implementation of our Community Service Learning Project. We conducted a windshield survey to identify a problem in the community and then plan an intervention to help address the issue. We found that there was little knowledge of the prenatal care resources in the community as evidenced by the high numbers of low birth weight, infant mortality, and preterm births. Our intervention was to hold a tabling even where both educated the community on prenatal care and the resources available to them in their community. We held the tabling event in the lobby of Kings County Hospital as to minimize the safety risk and maximize the number of people we could reach during our timeframe. We reached seventy people in the community. This was an overall success because the goal was fifty people.

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.

This semester I learned the importance of effective communication. On the first day of clinical, I made it my task to establish a clear channel of communication with all members of my clinical section and the professor. I gathered all the contact information and created a group chat where we could share information with and reach everyone in the section. While in the OBGYN clinic I helped by collecting client vital signs prior to being seen by the doctor. I assured that each client’s vitals were reported to the nurses for documentation after each client. I was sure to adjust communication with each client to make sure they knew what I was doing and why I was doing it.

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

Establishing a learning environment conduce to learning is perhaps the most important aspect of client teaching. During the tabling event that was held as part of the Community Service Learning assignment, we assured that pamphlets were available in the languages that we assessed were spoken in the surrounding community. We distributed pamphlets in English, Spanish, and Haitian-Creole. Many of the clients were glad to see the information in their language because many had reported that English was much harder for them to read and made learning undesirable for them. At the end of the event, we had a total of seventy people come to the table and receive information.

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

            The utilization of nursing informatics was key to my success in this semester. I researched and reviewed plenty of data for the community surrounding Kings County Hospital. My clinical group was tasked with developing a service learning activity for the community. Without this data, we would not have been able to assess the need for teaching in the community. We would not have been able to get the statistics of preterm birth, infant mortality, and low birth weight births. We also would not have been able to find out about some the resources for prenatal care available in this community.

This semester I did not have any access to client records. But I did record vital signs for clients in the OBGYN clinic. I recorded the vitals on a plain sheet of paper with the only identifier of clients being their initials. Once the vitals were reported the paper was shredded. I employed this practice as to reduce the risk for a break in client confidentiality.

Objective 6: Demonstrate a commitment to professional development.

This semester I was very committed to professional development. This being my final full semester before I graduate with my BSN, I made it my goal to gain as much insight into community nursing as I could. I used the textbook and I read through many of the pamphlets and posters available at Kings County Hospital to gain a deeper understanding of community health needs. I came to find out that I have developed the proper communication skills to be able to converse with clients at all stages of development effectively.

Objective 7: Incorporate professional nursing standards and accountability into practice

This semester was not my first time at Kings County Hospital. I have been placed here for four different clinical rotations. I choose Kings County Hospital because they have a mission that I can stand behind. Their mission is to provide clients with the highest quality of care. I understood my role as a student while I am at Kings County Hospital, regardless of my status as Registered Nurse. I understood that I would be held accountable for my actions. I also understood that there were restrictions on what I could do while I was at the clinical site.

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

The entire purpose of the Service Learning Project was to collaborate with peers to develop an intervention to provide teaching to the surrounding community. Luckily, I was grouped with fellow nurses who had excellent nursing skills. We collaborated with the Prenatal care clinic to gather the information we needed for our project. We also made it a goal to assure that we provided information in languages other than English to improve the level of learning. We also gave information on resources for family planning. I feel this assignment was good because it not only gave us an opportunity to provide teaching in the community, but it also gave a glimpse of the different people served in the community and the different educational needs that were left unmet.

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

During this semester, I conducted research to gain insight on the needs of the community. I found that a large amount of the community did not have insurance and for this reason they feel they are ineligible to receive many of the resources available to the community. This truth was more apparent when I was educating people on the prenatal care resources during the service learning project. There were people who said to me they didn’t feel they could to get prenatal care, to which I replied that many of the resources provided for prenatal care were free. I encouraged this person to take a list of the resources we made available at our event and ask them to follow up with any of the resources they felt they could improve from.

Conclusion:

Overall, I feel this was a successful semester. I delivered my first community health intervention through which I feel I made a difference. I demonstrated how a professional nurse behaves in a community environment. I took part in an assessment of the community. I was able to target an issue in the community and address it along with a team of fellow nurses. I improved on my communication skills to a level where I feel more comfortable with communicating with clients in a community setting. I learned new skills to improve on my client teaching abilities. I learned that preferred language plays a key role on a client’s willingness to learn. I learned that there needs to be a willingness to learn on the part of the nurse as to be able to find updated information to teach to clients. I also learned that proper collaboration is necessary to assure accomplishment of goals when it comes to teaching in the community. Different perspectives will be needed to see different issues that arise and to address these issues as they arise. I look at the learning experience gained in the semester will help me grow further both professionally and as an individual.

This is a website cataloging my growth from a nursing student to a RN