Introduction

This semester my community clinical experience was held at Stein Senior Center here in Manhattan. According to their mission statement, the center prides itself in cultivating friendly relations among the members of the Stein Senior Center and the general public; providing services with an emphasis on group growth; sharing the strengths, and wisdom of senior citizens; referral services, and to safeguarding the health and wellness of senior citizens. This experience was amazing. It showed me the value of maintaining a healthy lifestyle in my youth, so that I can enjoy my old age with great vigor. This paper addresses my experience this semester with promoting healthy living and educating on the prevention of disease and health problems among these seniors

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

Client confidentiality was always maintained as it is delineated in the Health Insurance Portability and Accountability Act. Blood pressure findings were documented using numbers, instead of names to identify the client and maintain their confidentiality.  I made certain that for every clinical, I had my stethoscope and blood pressure with me so that I could assess the clients properly. Upon several interactions with the seniors, once I divulged that I was a nursing student from NYCCT, they would ask me to take their blood pressure so I made sure that I was always prepared. I made sure that assignments were completed by the deadline.  My professor shared knowledge, attitudes and expertise that invoked the role of a facilitator, resource person and role model in the learning process whenever I would seek further guidance. I was always punctual and adhered to the college’s policy on clinical attendance. I always complied with the dress code ensuring that I maintained appropriate and professional attire and had my NYCCT ID displayed at all times.

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

During client interviews, I conveyed information in a manner that was complete, clear and concise. During blood pressure screenings I ensured that the client’s were aware of their blood pressure readings and answered any questions and concerns they had. Although, I did not physically administer medications to the clients, I reinforced patient education, which is a key intervention to assist older adults with medication management and adherence. Sometimes, during blood pressure screenings, I would get an abnormally high reading that would prompt me to investigate further. Was this a baseline for the client? Had they just had coffee? Are they remembering to take their medication every day?  I would notify my professor in a timely manner and suggest they follow up with their PCP. In order to evaluate the outcome of my nursing care, I would follow up with the client at the next clinical meeting, and inquire if they were able to manage the blood pressure and reinforce the importance of medication compliance as well as health promotion practices, such as watching the nutritional and salt intake.

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 cultivates collaboration and helps avoid errors. Given the change in the cultural makeup of the United States, we as healthcare clinicians are being challenged like never before to provide cross-cultural care that is sensitive, effective, and meets the needs of the patient and family. I was mindful of my own cultural beliefs, values, and behaviors and how it would affect my interactions with these clients. I listened empathetically and was always respectful as I engaged with clients from different walks of life.

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

The World Health Organization (WHO) defines health promotion as a process of enabling people to increase control over and to improve their health (WHO, 1986). To facilitate that process, we must provide people with appropriate information. I played a key role in providing that information in the form of health teaching at the center. Whether I provided information on Cancer Awareness or I was providing information on medication, I used every interaction with the clients as an opportunity as an educational intervention, to teach them how to set and achieve their health goals.

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

The different types of available technological systems these days require the nurse to ensure that they remain competent with this emerging technology more than ever. Today’s nurse must possess skills that enable her or him to integrate technological advances and computer literacy to ensure effective, quality care to clients. I used the information from Healthy Profile 2015 to elicit careful environmental health histories and look for trends in exposure, illness, and injury. I discovered  cancer was the #1 cause of death in this particular community and so I presented information to raise awareness on cancer prevention.

Objective 6. Demonstrate a commitment to professional development

As part of our commitment to being patient’s advocates, I feel that obtaining higher levels of education is imperative to our nursing practice. I was always encouraged by my mentors to practice to the top of my profession. Nurses are expected to incorporate critical thinking skills with evidence based practice. This is why it is important not to remain stagnant in our studies, but to always to strive for higher education, professional development and advanced degrees. Especially in this post digital era, patients are finding ways to manage their own health. They can search the Internet, where information is readily accessible, ranging from their diagnosis to treatment options. This should empower us as nurses to continue in pursuit of higher levels of education and training so that we can provide the quality care that our patients deserve. I provided critical information between epidemiological data and clinical understanding of health and illness as it is experienced in these clients’ lives. We were given an opportunity to learn about SBIRT and Emergency Preparedness which aided in my professional development.

Objective 7. Incorporate professional nursing standards and accountability into practice

 The American Nurses Association (ANA) provides leadership in determining the goals, objectives, and professional practice of nursing. ANA defines nursing as “… a caring-based practice in which processes of diagnosis and treatment are applied to human experiences of health and illness” (ANA, 1994). I critically analyzed interview data and assessment findings that relate to the specific needs of the seniors. For example if blood pressure readings were not within desired limits, I informed them of the finding and reported it to my clinical professor in a timely fashion.

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

Team collaboration is essential. The greater the team work and the support for vision and creativity the more likely the team will be motivated.  When health care professionals are not communicating effectively, patient safety is at risk. Collaboration in health care is defined as health care professionals assuming complementary roles and cooperatively working together, sharing responsibility for problem-solving and making decisions to formulate and carry out plans for patient care. For example, during our jeopardy project to discuss cancer awareness, I collaborated with my fellow classmates to create questions and set up a fun game that would engage the seniors. The seniors were provided with small incentives to participate and received a plethora of information on health promotion, disease prevention and maintenance of health.

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

The Stein Senior Center is not only a place where seniors can gather socially together and eat a hot meal. They also provide a comprehensive array of help with benefits and entitlements such as:

• Applications for Food Stamps
• Housing Issues
• Simple Wills and Legal Problems through Volunteers of Legal Services
• Elder Abuse
• Nutrition Education and Individual Counseling
• Help from HICAP specialist with government benefits and entitlements (Medicare, SS, SSI, Medicaid, etc)
• Lectures on financial planning, health and wellness

And that’s just to name a few. The senior center provides stimulating and supportive activities to over 100 seniors. It offers a computer lab and enrichment classes and activities from opera appreciation to belly dancing. There is no fee for joining, and membership is not obligatory to participate in most programs and activities.

Conclusion

In conclusion, this clinical has thought me the value of a community health nurse. There is so much more to nursing besides being by the bedside. The expectations of a present day professional nurse and all the accompanying responsibilities can prove to be rewarding if you are doing what you love and it’s wonderful to know all your options. I have learned how to make health information easy to understand, so people can take greater control over their well being. This experience reinforced my ethical and transcultural awareness when dealing with such a diverse group of people. Overall, I think having this tool under my belt can open more doors for me in this field of nursing, and now I am well equipped to go wherever this journey will take me.