Narrative Self Reflection

Introduction: For this Fall semester of 2015 my clinical site was located at Kings County Hospital Center in Brooklyn, New York. I was assigned to the Women’s Health OB/GYN Clinic located in the Ambulatory Care Center better known as the “E Building”. During this semester nine objectives were met and this narrative will elaborate on how they were met.

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

Every Tuesday that I attended my clinical rotation I was well dressed with clean professional clothes and my lab coat with my Kings County student identification card present. I was respectful to everyone I encountered. I came on time and if there were any problems I made my clinical instructor aware. I contacted my team members in a professional manner through text, phone and email. Privacy was granted to every client to abide by HIPAA law. Every week I participated in pre and post conference by sharing my thoughts and listening to others. I prepared myself every Monday night for clinical the next morning.

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

I was not able to do patient interviews alone but along side the registered nurse I did initial assessments for pregnant women who came to the facility for care. Together we would address all issues related to their health to correct it or find help for them. We would ask about their emotional state because this could have an effect on their well being as well as the unborn fetus. We also got familiar with their culture, and religious practices. I was not able to do a physical assessment or administer medications in the clinic but I took vital signs. After a patient was seen by the nurse I would watch how the data collected was documented. I also did research on diabetes and brainstormed ways in which my classmates and I could raise awareness in the community.

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.

Before therapeutic communication was initiated with clients I was introduced by the nursed as a RN student to make them more comfortable with me being in the room.I was polite and respectful to everyone I spoke to. I asked questions and listened attentively when I was spoken to. I spoke with an appropriate tone of voice. When clients spoke I also paid attention to non verbal ques such as body language and facial expression. When clients could not speak English an interpreter was reached to make communication easier for both the nurse and client. The nurse I shadowed showed me how to document the data collected in the computer. At the end of the day I communicated in post conference to speak about how my day went and what new or interesting things I saw.

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

During the first few weeks my classmates and I did a windshield survey around the neighborhood to find out trends in the community. After doing research on the community we found that diabetes was prevalent so we set out to raise awareness. We set up a tabling event which was used to identify people who were at risk of diabetes or who already had diabetes. Our primary purpose was prevention by way of diet and exercise. We offered gifts to people who participated and showed interesting facts of diabetes. We had visual aids to capture their attention in the lobby of the hospital. We had referrals to seek further information after our awareness session.

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

I was not able to access the computer on my free will but with the registered nurse I was able to get in the computer to see health information. The nurse would log on with her card and when she left the computer she logged off. She did not leave health information laying around. Information was not shared with anyone who was not pertinent to the care the client received. She would print hand outs that gave information on anything pertinent to the client’s health such as medications, procedures and breast feeding. Any information that was no longer needed was shredded. When patients could not speak English a translator phone was used to make conversing more convenient. I used my computer at home to do research on information needed for my service learning project. On a weekly basis my class instructor would ask on Blackboard blogs how was the project progressing.

Objective 6: Demonstrate a commitment to professional development.

I used up to date information when looking for information to complete my part of the service learning project. I am a registered nurse with an associate degree looking to receive my bachelor degree. I want to be a pediatric nurse. I learn new things everyday that I can apply to life as a nurse. I know that there is a lot more to learn especially since I do not have much work experience. I can always make room for improvement as a nurse. I am a home care nurse and this slightly falls under community health nursing. As a home care nurse I am alone in the home with my patient helping out with things that need to be done such as tracheotomy care and gastronomy feedings. In community health care it is more about prevention where hospital jobs is more of acute care. As a community health nurse there is a lot of teaching. I am not a big speaker so I would have to work on that aspect.

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

As a registered nurse I followed the American Nurses Association Standards. I followed the code of ethics and conducted myself in a professional manner at all times. During the first week of clinical I was given a booklet with Kings County Hospital policies and procedures as well as mission statement. I complied with all rules and did as I was told. I was aware that I was working under my license so if anything happened I would be held accountable.

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

I was able to work with nurses, classmates, my clinical instructor and patients. I helped out by taking vital signs and recording it on a sheet. I took patients sheets to the front desk to get registered. I was able to work with nurses from three suites. I met a support woman with my colleagues who gave us vital information on how to conduct our tabling event. She taught us about diabetes. At the tabling event I collaborated with clients to raise their awareness about diabetes. My classmates and I put together a service learning project to implement strategies to decrease the prevalence of diabetes as well as managing it on a day to day basis. My clinical instructor shared interesting information with the group every week and we had discussions on any current event in health around the community.

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

While in the Kings County community I saw that there are different factors that affect health care. Some people do not have health insurance and can not afford health care. Some people come from countries where they do not keep up with their health. Some people can not afford to buy the proper meals to stay healthy. Some neighborhoods do not get the services that other neighborhoods are offered. Crowded hospitals discourage people from coming because they are reluctant to wait. The type of care given by nurses and other disciplines are a big factor in whether or not a patient will come back to receive care. Some people do not have the proper education to understand their health. Kings County was a city hospital that gave care to everyone regardless of ability to pay but there were gaps. At the tabling event I was a change agent trying to teach these clients about this prevalent disease and ways to prevent it. On a weekly basis I was also an advocate along side the nurse to make sure each women that came received the proper care that they needed.

Summary: This clinical rotation was different from any other clinical that I have been to during my years of schooling. Not only did I appreciate the group work but I appreciated learning about the community trends. Being in the women’s health clinic I enjoyed seeing procedures done such as a colposcopy. I learned how to collaborate in a group to get an assignment done. The nurses from the clinic were very helpful and motivational. Every week I said to myself some day I will be a nurse delivering care on a day to day basis and I appreciated all information that they shared with me to increase my knowledge.