Narrative Self Reflection
My summer 2015 Community Health Nursing class was held at the Stein Senior Center, located on 204 E 23rd St 2nd Floor, New York, NY 10010. It was one of the best clinical sites I have experienced during the RN-BSN program at New York City Technical College. There were nine objectives to fulfill throughout this clinical rotation, which I will discuss in depth below.
Objective 1: Demonstrates individual professionalism through personal behaviors and appearance
Individual professionalism is of the utmost importance in the nursing field. I wore business casual attire and was well groomed at all times throughout the clinical rotation at The Stein Senior Center. I maintained client confidentiality by speaking to clients in a closed office setting while on the phone performing follow-up assessments. Privacy was also provided while performing blood pressure screenings. The clients signed their names and I recorded their readings next to their names while keeping face down to others could not see personal information. My cell phone was placed in my back and turned off. I also assumed responsibility for my own learning by interviewing Mr. Angel Burgos on certain policies and procedures of the center. Clinical learning preparation was also done before I went to the clinical site. My bag was packed with a stethoscope, alcohol pads, and sphygmomanometer, and clothing was prepared the night before clinical. All my assignments were completed in their designated time frame. I checked blackboard three times per week for scheduled assignments and utilized the provided syllabus for reference as well for scheduled due times. Guidance for my expected role and duties was provided by Prof. Egues. I discussed any concerns I had prior to any interaction with the seniors and staff. The director Bob Doxsey and general worker Angel also provided guidance for any questions I had for them. Clinical conferences were held Tuesday and Wednesday from 9:00am – 9:30 am and 2:00pm – 3:00pm with Prof. Egues and my classmates. We were encouraged to participate in the clinical conferences using an open discussion style, which I found very inviting and useful. I arrived at the Stein Senior Center at 08:15am and left at 3:00pm for our afternoon class starting at 5:00pm which ended at 07:30pm.
Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.
My clinical group and I applied analytical reasoning and critical thinking skills when providing care to the members of the Stein Senior Center. I conducted interviews and blood pressure screenings with the seniors while maintaining confidentiality and observing HIPAA guidelines. I worked in conjunction with the deputy director Bob Doxsey to perform follow up phone assessments on home care needs of some of the seniors within a private office. Vital information was gathered such as caregiver assistance at home, last medical appointment visit, medication adherence, eating habits, and need for further home care assistance. In addition, my clinical group and I had conversations with some of the seniors prior to lunch service. I interacted with the seniors discussing their day to day activities as well as their general outlook on life. These discussions gave me insight on not only levels of health care, but on their emotional state as well. My clinical group and I used analytical thinking to assess the vital needs of the community. I participated in group discussions pertaining to ideas for our service learning project and overcoming communication obstacles when interacting with the seniors. I wore a hairnet, gloves, apron, and used proper hand washing techniques while serving lunch.
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.
The Stein Senior Center has seniors from various cultures that attend services daily. I assessed the language level, hearing level, and speech pattern of each client to effectively communicate with them. All the seniors that attend the center are alert and oriented. They all verbalized their needs and concerns. The seniors that didn’t speak English had a friend that could translate, which enhanced communication between us. I discussed the goals of the day with Prof Egues and my clinical group. We each had various responsibilities and helped one another without issue when necessary. I listened patiently to concerns, showed empathy, smiled, and had a positive attitude at all times with the seniors and my clinical group as well. Phone calls to seniors and possible blood pressure abnormalities were reported effectively to Prof. Egues without issue. Some of the seniors were anxious when it came to lunch options and I learned to be efficient with time when serving meals.
Objective 4: Establish environment conductive to learning and use a plan for learners based on evidence-based practice.
I developed and implemented a teaching plan for an adult in the community setting with the help of my clinical group members. We presented an information session on the DASH diet. We initially researched what the DASH diet composes of, its benefits, and most affordable sources of food for this diet. My group included Ruth Pierre and Hlawn Aung. We brainstormed on presentation ideas, our individual parts, and what food options to bring to distribute for the seniors. We introduced ourselves, discussed the goal briefly, and encouraged the seniors to participate in our presentation. We provided fruits and bread for completing the pre and post test and asking questions during the information session. Our group posted flyers and handed out brochures that included the important points of The Dash diet to establish an environment conducive to learning. Lastly, we reviewed the questions and answers on the pre and post-test for the presentation. I assessed their knowledge by asking the seniors to repeat what they learned from our presentation.
Objective 5: Utilize informational technology when managing individual and families in the community.
I utilized the computers in the lab at the Stein Center to research the health concerns of the immediate community this center provides care for. My cell phone was also a valuable informational technology tool that I utilized to look up certain medications. The members seemed confused on some of the side effects of their prescribed medication. Electronic records weren’t available for our use, but we kept organized logs for blood pressure screenings recording the findings with pen and paper.
Objective 6: Demonstrate a commitment to professional development
I showed a commitment to professional development throughout my clinical rotation. I have researched the various demographics and health disparities within the surrounding neighborhood in community district 6. The deputy director Bob Doxsey and I discussed the various reasons for lifelong learning as a health care professional and our responsibility to the community. Prof Egues also discussed the various professional opportunities nurses have in the current economic environment. Online resources such as nyc.gov and the class syllabus were utilized to plan care for our clients. I performed self-evaluations weekly with 4 blog entries and one discussion board entry. In addition, I participated in daily class discussions and completed the clinical evaluation tool from the syllabus at the end of the class semester.
Objective 7: Incorporate professional nursing standards and accountability into practice
The American Nurses Association Standards were adhered to in my clinical practice while at The Stein Senior Center. I provided the client’s with privacy while discussing their health care concerns. My behavior was professional at all times and I followed all HIPPA guidelines while handling client’s documentation. Abnormal blood pressure readings were done twice on both arms and reported accordingly within a timely manner. The deputy director of the facility B also reviewed agency policy, including emergency procedures on the first day on clinical. The mission of the Stein Senior Center is to cultivate friendly relations among the members and the general public; to 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
My clinical group worked together in a collaborative manner to address the needs and concerns of the seniors. We performed health related informational sessions that they found very informative and helpful, which helped guide the clients to make appropriate lifestyle choices. I also worked with the center’s social worker in making follow-up phone calls to assess the need of home care assistance for some of the seniors. In addition, alternative pain management interventions such as yoga, stretching, and other relaxation techniques were reviewed with the seniors. My clinical group also assessed the surrounding neighborhood for health care resources such as local clinics, hospitals, transportation resources, supermarkets, and housing options.
Objective 9: Recognize the impact of economic, political, social, and demographic forces that affect the delivery of health care services
My clinical group identified important health concerns affecting the surrounding community of the center. One of the main concerns we identified was a lack of affordable healthy nutritional options for seniors in community district 6. There is a disconnect between local politicians who are more concerned for the affluent residents and developers than the needs of seniors on fixed incomes. I discussed many affordable shopping locations such as Trader Joes located on 14th Street and the Farmers Market in Union Square. I also identified alternative health care resources such as nearby clinics and low cost pharmacies within the neighborhood. My clinical group reinforced the importance of preventative medicine and primary care initiatives in the community. We provided information to the members via brochures, flyers, and weekly informational sessions for proper assistive device usage, medication safety, and the DASH diet.
Summary
The experience I had at the Stein Senior Center was a memorable one that I will always cherish. I started the class with a small background of community health nursing since I have a visiting nurse, providing homecare to clients for the past two years. I understood the material in the textbook since it is very similar to my day to day work activities. I was pleasantly surprised with the level of activities the seniors enjoy at this center. They participate in strength conditioning classes, yoga, dancing, knitting, and various educational classes. My classmates and I participated in all the events that the seniors enjoyed as well and we truly enjoyed ourselves. This experience has reinforced the importance of maintaining my health while I’m young to enjoy the same level of happiness these seniors have at the Stein Senior Center. The interaction I experienced with Prof Egues and my classmates was very enjoyable and I look forward in continuing my relationship with all of them.
