My Self- Reflection

 

Introduction:

For my Community Health Nursing class I was assigned to 107-109 Avenue D, which is part of the Community Access program. Thinking about the time that I have spent there, I have grown a lot and look at things differently when it comes to the mentally ill population. I have come to form a bond with some of the residents, which I didn’t think was going to be possible. They participated in the activities and groups that I held, which was very successful and rewarding to me. They asked questions and I gave them feedback. We set certain goals that were met and some still in progress. This assignment helped me summarize how I met my nine objectives.

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

Every Wednesday morning when I go to Community Access, I always take into account where I am going. I always remember to dress appropriately and act accordingly. I am very courteous to the residents. I focus on my goals for that day, and make sure they are met. I always participate in clinical pre and post conferences. I always ask for assistance when I need it.

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

I always have to remind myself that I am not treating patients in the hospital when I go to community access. In the hospital, the patient’s symptoms and diseases are treated. The patient is not treated as a whole.   In the community, you have to look at the patient as a whole. Psychological and physiological needs have to be addressed especially with the mentally ill.

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.

Community Access is a very diverse place. All the residents are very welcoming and looks forward to us coming every Wednesday. These short amount of hours that are spent with the residents are very rewarding. When I speak to the residents, I always make sure not to interrogate or judge them on their behaviors or actions. I first try to find out if they are aware of their behavior and the reasoning behind it. We set goals to see if those behaviors can be altered and eventually change them for the better.

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

I conducted two groups. One was during nutritional hour. The topic was reading nutritional labels properly. The second group was on tobacco harm reduction. The groups were very simple. It was a discussion. The residents were asked questions and their thoughts during the discussion. Nobody felt like they were being interrogated. They were not told to stop doing the harmful behaviors. I just merely suggested other ways to implement certain things, or do things. At the end of groups goals were set, and some were met.

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

Objective was not met.

Objective 6: Demonstrate a commitment to professional development.

This community class has opened my eyes to community nursing. I was never interested in community nursing until I took this class. I was unaware of how much work goes to being a community health nurse. I am curious and want to learn more. I want to broaden my horizon. I will definitely incorporate the things that I have learn in this class in the hospital setting as well.

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

Everything that I did in Community Access is within the scope of my practice. I followed the rules of Community Access by taking into account the type of people that they are serving. I understand that I am to look at the patient as whole, and not force by beliefs upon them as to what they should or shouldn’t do.

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

Talking to the residents about their health and psychological issues they are having, I believe has really helped them in a major way.   Some of the residents are very fearful of doctors and believe that they don’t help them. Letting the residents voice their fears and concerns and giving feedback has really helped them to look at things in a new light.   Some goals were set and met. Others are still working on theirs.

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

Economy has a huge impact on the residents at Community Access.   Community Access provides low income housing to people with psychiatric problems. Many of the residents are not able to afford much. Most of the residents are on SSI, social security and have section 8. The Community area is very expensive. Some of the residents don’t feel welcomed because of stigma that goes along with psychiatric diagnoses. Some residents don’t have enough money sometimes to eat properly, which contributes to their declining health. I graduated from NYCCT in 2005 with my associates in nursing.

 

 

Summary:

I began working in the hospital in2006 and got very comfortable.   After taking a long break, I decided to return and get by bachelor’s Degree. For the fall semester of 2015, I am taking community nursing. I was never really interested in Community nursing. When I found out the clinical site mainly focused on the mentally ill, I was very nervous because I never had to care for the mentally ill person as a whole. In the hospital we don’t really treat the whole person. We only treat the symptoms or the disease. In the community setting, the client has to be treated as a whole.   The clinical site I was assigned to is community access. Community Access provides low income housing and support for people with mental illness. On my first day of meeting the coordinators, I was very nervous because I was not sure how the residents were going to receive me. To my surprise they were very welcoming.   I introduced myself and they introduced themselves as well. I informed them that I was going to be there once a week and if there was something that I could do to help them, to let me know. I was very happy about community access. The response that I received just made me less nervous around people with mental illness. The objective for community access was to get new insight on the mentally ill and also to learn how to communicate and see the person as a whole, and not define the person by their mental illness. On my second week there, I met one of the residents that I have become very fond of. She was very happy to have me there every week. She started telling me about her personal experiences and the reason why she ended up in community access. I asked her about health issues. She told me that she has HTN, cirrhosis of the liver due to alcoholism, glaucoma in her right eye (left eye is a glass eye), hepatitis C, previous substance abuse, depression, schizophrenia and spinal stenosis which leaves her in pain all the time. She does not have a good relationship with her son because of the lifestyle she was leading. She self-medicates and drinks almost every night to numb herself and forget about her problems. I asked about how she feels about the things that she does to deal with her problems? She says she knows the things that she does, does not help her. But it a coping mechanism for her. After we had that conversation, she realized that I’m not here to judge her. I’m only here to give her insight and to listen to her and help her by setting goals that will help with behavior modification. Every Wednesday, she would be the first resident that I would see in the community lounge. She told me she looks forward to seeing me every week, and I also help her by letting her vent and talk things out. During my time at Community access, we held group meetings on nutrition and tobacco harm reduction which correlated with our service learning project. For the Tobacco harm reduction group we posted flyers on each floor of community access a week prior to the discussion and provided breakfast. Tobacco harm reduction was chosen because smoking a major issue with the mentally ill. During the group, everybody was asked reasons why they smoke and don’t smoke. To my surprise everybody’s answer was similar. Many smoke because of depression, to be cool, peer pressure, stress relief and the one person who did not smoke was because of cultural influences. I found it very interesting how much the clients knew about their smoking habit. They all realize the ill effects of smoking and want to reduce and eventually stop smoking. Some of the residents set goals, to reduce the number of cigarettes they smoke per day. The discussion group was a great success.   I feel that this clinical experience has given me new insight on Community Nursing and the mentally ill. I realize how much work a community nurse has to do, and it’s not easy.   It takes patients and time. At the end it’s all worth it when you get that special feeling inside.