Clinical self assessment

This is my narration on how I met and fulfilled each nine of my clinical objectives at PS 184.

I came prepare every day at PS 184, Newport, Brownsville in Brooklyn with in mind the intention to maintains patient confidentiality. The setting is different from a hospital or a clinic where Patient has charts and can be easily isolated in a room for a one on one conversation. PS 184 is a public school in a violent and poor neighborhood. We are assigned in this school to mentor kids that have parent incarcerated in the prison system via the AMACHI program. I maintain the patient (kids) confidentiality by avoiding talking about them in the hallway and avoiding involving nurses that are not in direct care with the kid. On report paper I use the kid initials rather than using his full name. I assumed responsibility of my own learning by reading and being familiar with the clinical evaluation tool to understand what is expected of me during this clinical. I further my knowledge with researching and preparing whatever topic we have planned for the kids for the following session. I also assume learning by arriving on time and actively participating in pre and post conference. I use the internet and my Mobil device as needed for further enhancing my knowledge and keeping up with updated information that are needed to teach and mentor. I prepare for clinical learning by going to bed early the previous day to wake up refresh, by arriving having read the previous day the material we are supposed to cover. More importantly I prepare for clinical learning by using the human resources in hand which are my lecture professor and my clinical professor.

I use efficient way of communication by conversing with the patient in a language that is more appropriate to his educational level. I use simple and concise sentences. I give the patient enough time to think and analyze the question before answering. I use open open-ended questions to get him to talk more about a particular event, all by being mindful of my body language and eye contact. Since the setting is in a school, I try to have the interview away from the other students. At first the students were more reserved, but by getting to know each other a relation of trust was built and they get to open up more, and share more information about them. While the neighborhood is unsafe, the school seems to be a safe place for the kids. Medication was never administered in that setting.

I effectively communicate with my professor and peers regarding pertinent information. The chain of command was always open and respected. The lack of one on one communication made it difficult to pinpoint major area of need for the kids. The kid`s instructor was the major source of information we had, in a sense she will tell us what is most needed for her students, and who needed help the most and the area of need. One of the topics she was concern about was sanitation; which we address by having a presentation on how to be clean. We acted out couple sketches by making fun of a smelly individual and at the end we offer them baskets filled with sanitary supplies.

I establish environment conducive to learning by making the kids comfortable in a safe and enjoyable setting. We establish that environment by always acting out the topic of the day. The kids were always receptive and participated a lot. We evaluate how efficiently they are learning by having questions and answers session at the end of each topic taught. The result was always positive and rewarding for us.

I utilize informational technology when managing individual and families in the community, by looking at nurse’s journal for related topic to be taught, and how to deliver it in the most efficient way. Patient confidentiality was not an issue in this setting in regard to informatics. But none the less confidentiality was always maintained in accordance to HIPPA law.

I demonstrate commitment to professional development by using appropriate and current literature in planning for my client. I understand, assume, and accept that the profession of nursing is a lifelong commitment to learning and constant self-evaluation. I, during this semester of community health nursing, understand the implication and the priceless value in being involved in the life and need of the community. Community nursing shows me another face of nursing, one that I identify most with. I intend after this class to be more involve in my community, do more teaching, advocating, and volunteer.

I incorporate professional nursing standards and accountability into practice, by abiding to the rules and regulations of the setting I was working in. A very important reminder on why compliance with agency standards is important. A situation arose when teen pregnancy and how to avoid it was being taught to the student occurs, where the student and one of the school instructor thought that the material presented to the students were not appropriate to their age group. I disagree because most kids in the panel seem to know a lot about sex and pregnancy with a lot of misconceptions. But again it was just that we were not acquainted with their policies. I as a nurse feel responsible and accountable for everything that takes place under my care, and there for I am mindful of the accuracy of the information I share with my patient.

I collaborate with clients by being available and giving my attention to them during every session. I try not to be judgmental by being open minded and by acknowledging my own limits. One of my client at PS 184 seem to be underweight , so together we identify foods with nutritional value available in the neighbor, he complains of being constipated and dehydrated very often and we put in place and identify ways to hydrate himself and regulates his bowel movement . This is one of the ways I guide my patient to make appropriate lifestyle and treatment choices. I make sure my client go to his follow up appointment yearly by asking question as to when he last visited the dentist for example. With the client we identify available clinics and hospitals in the neighborhood.

As a community nurse I have to be in constant evaluation of the cost, and the political changes that is taking place in the health care field, and the impact in the community. I also recognize the discrepancy in healthcare accessibility between poor and rich, and the impact of healthcare reform that is being implemented in the near future. As a community nurse it is my duty to learn and understand healthcare reform, the benefice and the disadvantage on the community, to be able to explain to the common person. I assume the responsibility of community health nurse by advocating for better care and accessibility to client and families.

In summary, the community health nursing program is one of the most important links that every nurse needs to adhere too, to be complete and feel fulfill. I was at first nervous going to PS 184, because I never been in a school setting before. Also mentoring kids that has incarcerated parent seem frightening at first. But eventually I feel that my presence and the teaching done fulfilled in part the role of a nurse in the community. I also believe more can be done to improve the learning experience for the patient and the nurse, by staging more one to one mentoring and more teaching material. This learning process helps me grow, by experiencing a new area of nursing, exchanging with a different group, in a different setting, with different material. The clinical portion could have been tied to the lecture by acknowledging the type of population we were dealing with, minority, poor in a dangerous neighborhood.