The community health nurse brings their skills and compassion to the clients natural setting, the community. This semester has allowed me to practice my communication skills while working in various settings and helping those who are less fortunate. During our clinical rotations, we provided blood pressure screening, body mass index measurements, and we also taught clients about healthy lifestyle choices. I had the pleasure of attending a health fair in Queens, working at the Salvation Army soup kitchen, and Our Lady of Refuge food pantry. The high volume of people attending these sites, better prepared me for the fast work pace we will experience as working nurses.
Objective 1: Demonstrates individual professionalism through personal behaviors and appearance.
Having been away from the profession of nursing for a few years, my top priority was to review information about blood pressure and body mass index. As nurses, we have to seek the latest information about care and we have a lifelong commitment to continuing education. If any questions were to arise, I would seek information from Professor Gellar. Our client’s anonymity is of utmost importance, and we assured them no information would be shared with anyone else. We provide an atmosphere where everyone is invited and no judgements will be cast. These clinical settings allowed us to dress in business casual attire and I must say that I always came dressed well. I take pride in my appearance and I want the public to know that I’m a professional and will carry myself as one. I made it on time and in style.
Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.
Interviewing clients is the only health history we can obtain because there is not electronic system in use at the clinical sites. As with any evaluation, I always observe the client to see if there is anything noticeably different or wrong upon their approach. This assessment goes further looking to see if there’s any developmental, cultural, emotional, or religious influences on health. I noticed some people who had developmental delays so it could have had an effect on health status. Culture also has a large influence on health practices. Mostly because of the food that is prepared. When I think culture, food always pops into my mind because I love trying all types from different origins. During the interview I would ask about self-care needs and a lot of people had problems with it. Seems like medication adherence or lack of medication was the biggest problem. As far as physical assessment, only BP and BMI measurements were taken. Because of the clinical site, there was no medication administration or treatments. Prioritizing care was mostly health teaching to make sure the client has an idea on how to remedy their problem. With the flow of clients and different health scenarios constant, my mind was always in reflection on what could be taught. When the same patients came back, I would check to see if they remember what was taught to them. Some people had real interest in changing their behavior. I also ran a safe practice making sure the client and I were not in harms way.
Objective 3: Effectively communicate with diverse groups and disciplines using a variety of strategies regarding the health needs of the individuals and families in the community setting.
Effective communication is one of the most important skills a nurse can have. The clients who visited the clinical sites spoke Chinese, Spanish, Creole, Russian, and Polish. I speak conversational Polish and was able to talk to a gentleman who came to the soup kitchen at the Salvation Army. My Spanish is not that good but I was also able to speak to the clients about health history, diet, and medications. If I’m having a hard to explaining something because of a language barrier, I will use pictures that we had or even body language. My communication style is very therapeutic, I try not to seem judgmental and I speak with a soft and comforting voice. Besides communicating with the clients, I converse with my classmates and Professor Gellar regarding certain findings or if I’m looking for someone else’s input on a subject. The only documentation we did pertained to BP and BMI readings in the little pocket record keeper the patient carries and the sign in sheet.
Objective 4: Establish environmental conducive to learning and use a plan for learners based on evidence-based practice.
The role of teacher is one of the most important functions in nursing. Depending on knowledge deficits found when speaking to the client, appropriate teaching would take place to inform them. Although it could get hectic in the screening area, some teaching was done with every patient no matter how busy it got. Our most important lesson taught was to the volunteers at Our Lady of Refuge Church. At the last clinical day, our group did a presentation on diabetes. The volunteers were into it and retained most of the information that was taught as indicated by the post test that they took. This teaching was especially important since we’re now gone but what was taught will be passed on to the clients who attend these sites. I hope they are as enthusiastic about teaching as we were.
Objective 5: Utilize informational technology when managing individual and families in the community.
Nursing informatics was none existent in this clinical setting. The most high-tech equipment there was our cellphones. We had the basics which included electronic blood pressure cuffs and a scale to weigh patients. BMIs were calculated through an app on the cell phone. Confidentiality is always maintained in the clinical setting. No records including any personal information are collected by us. Some clients were not even comfortable signing their name on the attendance sheet fearing the information would be used in some malicious way.
Objective 6: Demonstrate a commitment to professional development.
Medicine is constantly changing and new literature can be found daily. It is the nurses job to stay up to date with current information. Community health nursing is the wave of the future as health care will be provided in the community setting in the hopes of preventing illness. This position has a lot of autonomy which means the nurse must be highly motivated on their own. The possibilities that one can create make this evolving job appealing and challenging at the same time. As mentioned earlier, nursing is a lifelong commitment to learning. We should also be committed to doing research or least partaking in it to further the profession. Daily appraisal of my own work is something I engage in. Sometimes you can be your own harshest critic.
Objective 7: Incorporate professional nursing standards and accountability into practice.
NYU Lutherans New Faith Health Partnership allowed us to participate in their mission to “bring together faith groups serving the diverse interfaith community in a shared spiritual endeavor to improve the health and wellness of everyone.” As volunteer workers, I complied with the agency’s standard of practice and I was held accountable for my actions. The profession of nursing is held in high regard and we must adhere to the American Nurses Association standards. I provided competent care by using the nursing process whilst using the latest information available, and doing so in a safe manner.
Objective 8: Collaborate with clients, significant support persons and members of the health care team.
Communication amongst staff is incredibly important to provide quality care. We are a cohesive group and always communicated in a professional manner when it concerned patient health. The clients who frequented our sites became very open to our presence and befriend us. Through our interactions, we worked with them on creating interventions that would them achieve a higher level of wellness. Our expertise allows us to direct clients to make healthier lifestyle choices. There are multiple ways of attaining this, and they chose the most convenient way for them. Some patients did not have proper insurance so I was able to help them by distributing a flier for a clinic associated with NYU Lutheran to get them help.
Objective 9: Recognize the impact of economic, political, social and demographic forces that affect the delivery of health care services.
Even with recent changes in health insurance policy, many people are still not covered. The communities we worked with are definitely underserved. In this world focused on money, people fall through the cracks. I’m proud of the work we did with the clients providing screening and trying to get them access to medical services. Community health nursing has truly opened my eyes to the shortcomings of the health care system that is currently in place. Lack of resources has improved my critical thinking and and problem solving skills.
My role as a nurse in the community setting was one I enjoyed. Its challenging work trying to coordinate care with outside providers, especially when the client has limited access to funds and is uninsured. I carried myself as a professional and supported the client in their effort to regain or maintain their health. My lifelong commitment to caring for people will only gain strength as my career continues.
