Introduction
In the fall of 2014 I had the opportunity to take the community health nursing class, and as a part of the requirements for the clinical class I attended the Stein Senior Center located at 204 East 23rd street. Nine objectives were established to be accomplished by the end of the semester for that class. I will explain in details how my objectives were met during my clinical experience in the Stein Senior Center and the work I had to do each week in order to complete successfully my assignments.
Objective1: Demonstrates individual professionalism through personal behaviors and appearance.
During my clinical class at Stein Senior center I maintain client’sconfidentiality; I did not state any names in any of my blogs or conversation with my classmates or outside the center. I participated in different activities at the center and had conversations with the members of the center on multiple occasions. I came to my clinical class well prepared, and participated in all discussion that we had with the professor and the stuff of the center. I completed all my assignments, blogs and discussions within designated time frame. During our conference I asked the professor questions regarding future assignments and projects that I had to do and I received appropriate guidance. I arrived to my clinical side ahead of time to avoid lateness. I make sure to look professional and maintain the dress attire by dressing appropriately all the time.
Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.
During my clinical class at the center I communicated with the director of the center and other staff members involved in the activities of the center. Also I had multiple conversations with the residents of the center. While talking to the residents I understood how aging affects them, about activities they used to like to do, but unable to perform anymore and about the disease they have and how it is affecting them physically and emotionally. At the center the residents participate in many of the activities that take place there like: thanksgiving party, Hanukah celebration and Christmas celebration. For some of the residents this center is the only place that they can enjoy the Holiday, so for them is very important to attend the center. As a student, I directly participate in the preparation for the Holiday baskets, for the raffle that will take place at the center by bringing small gifts as part of the basket presents. The Holiday time is a very spiritual time for older people and some of them have good memories about it, that is why the center tray to accomplish a lot, by preparing the holidays for the residents, to increase the emotional and cultural spirit of the residents, at the same time increasing their well-being.
Most of the residents at the center are well dressed, clean and ambulate by themselves. Some of the residents are not so well dressed, meaning their dressing is not clean enough or not ironed and ambulate with the help of a cane or wheelchair. Even though all the residents at the center are very independent, from my observation I can say that some resident’s needs assistances with the daily living task and a community nurse would need to pay a visit at their homes and inquire about they needs.
Despite the fact that that I did not have a chance to perform a full physical assessment for any resident at the center, from the conversation with some of them and by measuring their Blood pressure I was able to understand if they taking their medication on time or if their visiting their doctors, what kind of knowledge they have about how the blood pressure medication work on their body, and what are the risks and factors of noncompliance with the medication. Though we were not supposed to administere medication at the center, but if I would have to I would make sure that all my patients gets the medications on time and I would do clear teaching about the medication they received, if this medication was given the first time. From the discussion with the residents about medications they are taking and about their knowledge of medication safety, it helped us to choose a topic for discussion for our presentation. Furthermore our presentation increase the knowledge of medication safety among the population of the center and after the presentation I was able to evaluate how well the presentation was accepted and the knowledge they got by attending it by encouraging them to ask questions.
When I was helping with the lunch at the center I made sure that every resident have a set while waiting for the lunch and that the hallway between tables is not overcrowded and they should be able to ambulate safely and prevent any falls or injuries.
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 center.
While at the center very often I conducted therapeutic communication with the residents. These were discussions about High blood pressure reading and about the medications they were taking. Many of the residents were very open to discussions, some of them were not. Some of the residents informed me that they take their blood pressure medication every day and they are ever of the results, some of the residents were not taking blood medication at all, as a result their blood pressure were not as good as it should be. Communication channels within the center were mostly verbal; otherwise, within my clinical group, verbal messages, telephones, e-mail, and the internet were our forms of communication. Communication between the employees was clear and brief and if additional information was needed I spoke to employs of the organization. If I did not understand something or I had any concerns about a project or about any assignments I express my concerns to the instructor. As I said before, since I didn’t do any assessment, document or report, I documented only the blood pressure reading and it was reported to my instructor the reading that were high.
Objective 4: Establish environment conductive to learning and use a plan for learners based on evidence-based practice.
I and another of my classmate prepared a presentation about medication safety. We researched information about medication safety and about medication boxes to help the residents take their medication on time and in a safe way. We prepared pamphlets and handouts about the medication safety and about different ways of keeping the medication safe. Also we had a three way displayed board with pictures of different types of medications boxes and how to use them. Besides that we offer the residents refreshments snacks and evaluated their knowledge from the beginning to the end of the presentation, before we started and posttest at the end.
Objective 5: Utilize informational technology when managing individual and families in the community
The Stein Senior Center has a computer room, this room is used by residents and we as students were able to use it. I used the computers when prepared the pamphlets for our presentation and when I needed to look up some information about questions that were asked by the residents. Resident’s records were no available to us; however I maintain resident’s confidentiality during blood pressure readings by not releasing the reading to other residents of the center and by not writing the residents name next to the reading.
Objective 6: Demonstrate a commitment to professional development
As I was conducting research for our presentation on medication safety I used evidence basedresearch and reliable websites to provide accurate and current information. I read a lot of literature on the topic and dedicated time to prepare for the project, in order to be able to teach the residents, and at the same time I had the opportunity to teach myself some fresh information that I gathered. As part of my self-evaluation, I analyze my work as a nurse, identifying my strength and weakness and ways to improve myself in work I perform. I will adjust to the new job situations that come into my track and accept any challenges, using them as a working experience in my nursing career.
Objective 7: Incorporate professional nursing standards and accountability into practice
Throughout my clinical rotation, I comply with American Nurses Association Standards by sustaining the responsibility to do no harm, to be fair to others and be helpful in preserving the wellbeing of the members of the center. I obey with the center’s standard of practice by participating in the activities that took place there, and held myself liable for my action at the center. I made myself aware of the center’s mission and observed the goals of their mission.
Objective 8: Collaborate with clients, significant support persons and members of the health care team.
While preparing our service learning project for the center we got information from the director about the needs of the residents and what would be a good learning experience for them. From that discussion and from our own experience of the needs of elderly people we decided to prepare the medication safety project. The employees from the center were very helpful in regards to printing pamphlets, and educational material for our project. As I was doing research about older adults I found out that many of them have problem in remembering to take the medication, so for this reason we brought a few types of medicine boxes and showed how to use them. Also we provided teaching about medication safety and how to be aware of side effects of new medication, and be prepared to ask the doctor about the new medication that was prescribed for them. Moreover we provided the residents with information on how to store the medications and how to discard the old medication.
Objective 9: Recognize the impact of economic, political, social and demographic forcesthat affect thedelivery of health care services.
After the presentation many residents voiced their concern regarding the prescribed medication they are getting in the doctor’s office. Also they admitted that very often they don’t understand the reason the medication was prescribed and they don’t know if any of the medicationshave side effects. Many of the residents admitted that they don’t like to go to the doctors and they are very happy when the center offer them the flu shot or other vaccines that they have to take sometimes. The center does not have their own medical personal and the nursing students are very welcome there. As I started my clinical at the center I observedthat the center have a place where some of the residents are exercising every Wednesday with the help avolunteer, but not all the residents are participating in that activity. I think that the center needs a bigger space for exercising in order to accommodate a larger number of participants. Also sometimes not all the residents have a place where to set during the lunch time because of a high number of people who are coming to have lunch there, so maybe they need to add some more tables and chairs in the lunch room. Moreover I know that the center exist based on donation and from the money they make by selling the lunches, and with the help of some organization. I think that if the center would have a nurse on premises the residents would feel more confident and would open more to the permanent nurse than to the students who are coming once a week there. By having a nurse there a lot of the questions that the residents come up with, would be resolved effectively in short period of time and the need to visit a doctor would be avoided.
Summary:
My experience at the Stein Senior Center was very interesting and rewarding. By being there I had the opportunity to extend my knowledge as a nurse in a community health setting. As I was there I learned how important it is to educate the residents about the issues that we encounter every day when taking care of older adults. Our group presented the center with four projects. Each of them was very important for residents in preventing medications errors, in preventing injuries due to unknowing how to use the walkers and crotches, in preventing the diabetes which is a silent killer and how to use the dash diet to prevent high blood pressure and loose weight. I think that the center benefited a lot by having us there together with the residents, because they found out new information about the important topics, got help with lunches and also gave me the courage to include this into my practice as a nurse, expending my career and changing the lives of individuals of all ages.
