Svetlana Polyakova

NUR 4010 Narrative Self-Reflection

In the New York City College of Technology I came to get Bachelor degree in nursing. This summer was my third semester, and I have taken a Community Health class that was five weeks long. It was a short semester, and I worked hard, because I needed to finish the same amount of the assignments that I would did in the long semester that lasts usually for twelve weeks. Moreover, one of the assignment was a service learning group project with the presentation, required a lot of my efforts and knowledge. As part of the group, I was engage in collaborative learning to work and solve problems with others students. In addition, one of the components of this course was the clinical experience in the selected community agencies, where I learned community health nursing through active participation among community partners using my skills and knowledge in real-life situations.

In this self-reflection writing I am going to describe clinical objectives and how I met this objectives as a student.

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

Professionalism involves much more than degrees and credentials.
It includes a certain work ethic, attitude, code of conduct, appearance, communication style. Every clinical day I came to the assigned clinical cite on time. I was dressed professionally, and I was prepared for the clinical learning. It was my responsibilities to read assigned chapters from the textbook. The advanced reading was helpful to participate actively in clinical conferences.

One of the community health course assignments was blog writing after the clinical day, and one comment for any classmate blog. I tried to write the blog as early as I could, not waiting for the last minute, thus giving my classmates the chances to write the comments for my blog.

It was very important to maintain client confidentiality. Being on clinical setting I knew how to follow this rule. When I participated in BP screening or BMI, the taken results I kept closed to avoid the result of previous client being seen by other client or someone else.

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

Providing care to individuals and families in the community setting, I realized that as community health nurses we need to utilize all steps of the nursing process. First I need to assess the impact of developmental, emotional, cultural, religious and spiritual influences on the client’s health status. The second, I need to collect significant data relevant to client’s self-care needs. The collaboration with other health professionals to collect client information is very important in order to get nursing and medical records. A completion of physical assessment is also very important in providing care. Based on analysis data collected I need to prioritize and plan my interventions, and then to implement them safely in timely manner. After intervention I need to evaluate the outcomes of nursing care, and modify client care as indicated by evaluation of client outcomes. Providing care in the community setting, safety principles should be considering administering medication and treatment to the client. A utilizing of personal safety should be considered as well. Since I did only BP screening, and didn’t administer medication and treatment in the clinical setting, I asked my clients about their medication taken, explaining about how important blood pressure medication compliance. Using sanitizer after each client I followed principles of personal safety and safety of my clients.

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

In my opinion an effective communication with diverse groups in the community setting is very essential part working CHN. In order to avoid a misunderstanding between nurse and client, or the mistakes caring for the clients, CHN has to utilize therapeutic communication skills and appropriate channels of communication. I tried to apply my communication skills while BP screening. When client came to check his/her BP I asked first if client spoke English. Most of the clients didn’t speak English, so I used a body language or showed the colorful BP reading charts with numbers of normal, borderline and high BP results to explain to the clients their results. Also I tried to communicate clearly and effectively with instructor, my classmates and the health care team, which composed of community nurse and volunteers. A documentation of the assessed findings and interventions accurately are the parts of nursing job. While blood pressure screening the special forms had to be felt out. I tried to write client’s information including first and last name, zip code, phone number, age, gender and language spoken clearly, because if patient had a high blood pressure result the phone call would be made to this client later. In this case was very important to have a clear writing in these forms.

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

The big part of CHN job is developing and implementation a teaching plans for the clients in the community settings, establishing environment conductive to learning, and evaluation client’s learning outcomes. Teaching my clients about diet or exercises, I used a reflective technique. I asked the clients to repeat what they are going to do in case if they had high blood pressures or they were overweight. Thus, I could realize if they understood my teaching, and evaluate their learning outcomes. If my clients didn’t speak English, I provided them typed information on their languages (e.g. Spanish, Chinese). However, I tried to make sure if the client can read.

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

Computerized clinical documentation is moving forward, so the nurses need utilize principles of nursing informatics in the clinical area and maintain strict confidentiality with the client record. Without computer literacy contemporary nurse will face the obstacles working in the computerized facility. Nurses working in the community also need to have computer skills in order to conduct scientific research.

While this semester we didn’t use electronic medical records on the clinical settings, however the assignments that we had in the lecture part of community class, and community project, demanded computer skills to search the information to do these assignments and project. I need to build up computer knowledge. For example while group project I had the difficulties to use Google groups to communicate with my classmates. I was nervous when I was not able to post my part of the project because of lack of some skills to use power points program.

Objective#6: Demonstrate a commitment to professional development

A nursing practice demands a continuous professional development. In planning care for the clients we as a nurses need to use appropriate current literature, assume responsibilities for lifelong learning, engage in self-evaluation, and adjust to the challenges of independent practice. Working on the community group project, I learned different concepts about community health nurse practice. These concepts like reflective practice, respect, vision, relatedness, clarity, courage, compassion, responsibility, flexibility, justice, precision, evidence-based future will help me as a nurse working in the community to think, feel, and perform nursing in different way.

Objective#7: Incorporate professional nursing standards and accountability into practice Professional nursing standards and accountability into practice include utilizing American Nurse Association Standards in clinical practice, compliance with agency standards of practice, accountabilities for actions in the clinical area and awareness of the assigned agency’s mission. I believe that knowledge of these standards and utilizing them is a guarantee our safely practice, and safely health care providing for the clients.

Objective#8: Collaborate with clients, significant support persons and members of the health care team The effectiveness of collaboration with care team to address client problems, and coordination client-care based on client needs and therapeutic interventions are the   parts of the nursing job that help to identify health care recourses for the clients, guide them to make them the appropriate lifestyles and treatment choices, and assist clients to make connection to other community agencies. Working on the community group project, and diabetic teaching session for the client, we practiced how to communicate effectively within group and collaborate to finish this project and perform the teaching for the client.

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

As a nurse I have to recognize gaps in care system, being able to find solution to complex problems, and to act as a change agent in advocating to appropriate health care resources for my clients. To be aware of any changes in health system and impact of economic, political, social and demographic forces that affect health care services, I always read the latest magazines and articles. I believe having the broaden knowledge about the health system can help us to be the good client’s advocates in solving their complex problems.

In conclusion, overall I enjoyed this semester. I think I did a good job when caring for the client on the clinical setting, and gathering the information for the learning project. However, I think I still need to continue my learning process as a community nurse for the personal and professional growth.