Narrative Self-Reflection of Service   Learning Project

 

Service learning combines academic study with community service to enhance learning, and to fortify communities. Through service learning, I use my acquired knowledge and skills to demonstrate competence in meeting the needs of the clients in the community. This clinical rotation took place at Kings County Hospital Spring 2018.

Objective 1. Demonstrated individual professionalism through personal behaviors and appearance

I demonstrated individual professionalism through personal behaviors and appearance by

Maintaining client confidentiality by not shearing client’s health information. I Assume responsibility for own learning by reading nursing journals to keep abreast with current trends in nursing, and attend to  nursing conferences. I  prepared for clinical learning by reviewing the assigned materials and practice the necessary skills needed for clinical, and Completes assignments within designated time frame by using time management, I also seek guidance appropriately from my clinical instructor when caring for a difficult or uncooperative client. I Participate actively in clinical conferences by asking questions and provide feedback to the group during pre and post-conference.  I attend clinical punctually by arriving on time and in accordance with school policy, dresses professionally, with the required lab coat over my clothing, and school ID visible.

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

I employ analytical reasoning and critical thinking skills while working  alongside the nurse in the GYN clinic while she was conducting an interview with a client, it gave me an opportunity  to used the client interview, nursing and medical records, staff nurses and other health professionals to collect client information for my community assessment.  I assess the emotional, cultural, and spiritual impact on the client’s health status during her consult with the nurse. The client’s blood pressure was elevated 170/88, have a history of hypertension. When the nurse asked the client about her medication and her diet the client replied “I forgot to take my medication yesterday, and I ate some salt mackerel.”  The nurse reminded the client of the importance of taking her medication and told her to avoid foods high in sodium. Based on my assessment of the community, East Flatbush consists of predominantly Caribbean culture. Their diet contains high carbohydrates, sodium and fat. Culture has a tremendous effect on the diet of the clients in the community, diabetes is a major health issue in the community followed by hypertension /heart disease and obesity.  Religious and Spiritual influences are highly regarded in the community. During an interview with the nurse, she indicates significant data were collected relevant to client’s self-care needs, and physical assessment was performed on selected clients on clinical visits. According to the nurse care is prioritized based on an assessment of the client problem, and  priority-setting is applied in planning nursing interventions. However the clients are very non-compliant, they do not return for follow up. I did not administer medications and treatment, but I witness the nurse administer multiple vaccines to an infant safely, and instructed the parents of the signs and symptoms of adverse effects to report to the doctor or take the infant to the emergency room, and apply an ice pack for minor swelling.

According to the nurse it is sometimes difficult to evaluate client outcomes because of non-compliance, most parents do not return for follow up especially after PPD is given.

I utilize principles of personal safety when working in the community setting by using hand hygiene.

Objective 3. Effectively communicate with diverse groups and disciplines using a variety of strategies regarding the health needs of individuals and family in the community setting

I effectively communicate with diverse groups and disciplines using a variety of strategies regarding the health needs of individuals and family in the community setting. During my clinical rotation, I observe the nurse utilizing therapeutic communication skills with individuals and families in the community setting by listening, and clarifying information when interviewing the client. I utilize appropriate channels of communication with the nurse when inquiring about the service that is provided in the GYN clinic for the clients. In post-conference I communicate clearly and effectively with the instructor, peers, and the healthcare team I discussed my clinical experience with the group, I learn about the different tests that are done in the GYN clinic such as colposcopy to check the cervix if a client has had more than one abnormal Pap test result.

I am able to communicate significant data to my instructor and the healthcare team, such as changes in the client’s condition but I did not have that clinical experience. I am able to adapt communication skills to the developmental needs of the client by communicating to clients on his/her level of communication, but I did not get that clinical experience. However, I observed another nurse report  to the charge nurse and document assessment and nursing interventions in the client’s clinical record.

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

I establish an environment conducive to learning and use a plan for learners based on evidence-based practice. My team and I have developed a teaching plan on the importance of getting the flu vaccine for our service learning project, but  it has not been implemented yet. Information for the project was obtained from CDC.gov. It is scheduled to take place in the clinic area, our goal is to reach out to ten adults. We think the environment is conducive to learning, and is expected to have positive outcomes upon evaluation.

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

I utilize informational technology when managing individual and families in the community. In the clinical area the nurses utilize principles of nursing informatics. I noticed that Electronic Medical Record is used in the clinic, the nurse informed me that it is convenient and especially  helpful when there is a  need to obtain health information from the Department of Health for non-English speaking clients.  I help the nurse use the internet to retrieve health information for a client who wanted more information on her fibroids. When I asked if the website used is valid, she assures me that they used valid websites at the hospital.

The nurse in the GYN clinic maintains strict confidentiality of client records, while reviewing a client’s medical record on the computer, the nurse was abruptly called away by another nurse, before leaving the desk the nurse logged off and closed the computer, when she returned logged in and continued the review of the client’s record.

 Objective 6. Demonstrate a commitment to professional development  

I  demonstrated a commitment to professional development through the use of appropriate current literature such as evidence-based research information to share with the nurse in planning care for clients in the community setting. I assume responsibility for lifelong learning through continuing education and  attending conferences to gain the competencies needed to provide care for the diverse client population in the community. I engage in self-evaluation by identifying my strengths and weaknesses. My weaknesses are areas that need development, and I am willing to work on improving those areas.    I am committed to adjusting to the challenges of independent practice in community health nursing through nursing competence.

Objective 7. Incorporate professional nursing standards and accountability into practice

I incorporate professional nursing standards and accountability into practice by I utilizing the American Nurses Association Standards in clinical practice to provide care within the scope of the nursing practice, and complied with agency standards of practice by following the policy and procedure guidelines for providing care to the clients.  I am accountable for my actions in the clinical area by being responsible.  I am aware of the assigned agency’s mission. In researching the agency’s mission statement, I could not help but notice how similar theirs was to mine. “My mission is to provide safe and best quality health care to maintain optimal health to all members of the community with integrity and compassion.”

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

I  collaborate effectively with the health care team to address client problems, such as non –compliance with care, clients not returning for PPD reading. The nurse and I discuss ways to address the problem. We were able to retrieve information from the CDC website about TB and the importance of the PPD vaccine as primary prevention. The nurse plan to use this information to give to the clients after the PPD is given.

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

During the community assessment and windshield survey I was able to recognize the impact of economic, political, social, and demographic forces that affect the delivery of healthcare services In the community. There is a lack of  fresh fruits and vegetables, and good restaurants to eat from in the community. There is an abundance of fast food restaurants directly across from the hospital. I am not surprised why many people in the community suffer from heart disease, hypertension, diabetes and obesity. The community needs more fresh food markets.

At Kings County Hospital all clients are seen with or without insurance coverage,  people from everywhere come to Kings County Hospital for health care. One of the gaps I noticed in the system is client teaching, it seems to me the reason  clients do not return to the clinic for follow up care is  due to lack of knowledge. The problem can be fixed  by teaching the clients what they should  do, and why it should be done. My team and I have developed a teaching plan on asthma and the importance of receiving the flu vaccine. However it is not yet implemented, we hope to make a difference in the lives of the clients in the community.

 

 

Conclusion

Service learning is an excellent way to integrate classroom learning with community service. It provides insight into the real-life situations and needs of the community, it gives an opportunity to actively participate and apply my skills and knowledge in real-life situations, and it provides me with a better understanding of the needs of the community.