Introduction
My clinical experience has opened my eyes to a new view on older adulthood. This experience took place at The Stein Senior Center located in the Gramercy Park area of lower Manhattan. The Stein center is a place where seniors can go to not only form new friendly relationships, but get help with safe guarding their health and wellness. After participating in a clinical rotation at the center, I now know what life can be as an older adult. All too often as nurses we see one side of older adulthood and that is when they are sick and hospitalized; however, there is more to aging. Becoming a senior doesn’t mean you will be fragile and sick. If you take care of yourself, and remain active you too can be as young as the seniors at the Stein Center. This self- reflection is written with the purpose of recognizing my abilities, strengths and things I needed to improve to provide quality care to the seniors of the Stein Center.
Objective 1: Demonstrates individual professionalism through personal behaviors and appearance
Throughout my clinical experience, I maintained the client’s confidentiality by providing data privacy as per HIPPA regulations. A perfect example is when a patient blood pressure was too high and needed to be referred to the hospital. I Pulled the patient aside into a private room and asked all necessary questions before informing them about my concerns and referral. I assumed responsibility for my own learning by coming to the facility on time and prepared with needed equipment such as my blood pressure cuff and stethoscope. I maintained a good line of communication with my professor as well as my peers for guidance if I should need it. All my assignments were handed in upon due date. I also made a point to participate actively during pre-and post-clinical conferences. Every day of clinical I came dressed professionally in accordance with NYCCT attendance policy.
Objective 2: Employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community setting.
During client interviews, I maintained an open-ended dialogue between myself and the client to gain a therapeutic relationship. This new-found relationship then allowed me to collect necessary client information. After taking the patients’ blood pressure, I utilized that time to answer any questions the client may have had. Whenever I got a high blood pressure reading on the clients, I would then inquire about their medications and medical history. Next, I would inform my professor about what I know about the client and the blood pressure results I had received. After enough information gained sometimes it would be imperative that we referred them to see their primary physician or the emergency room for further screenings. Although I did not administer medications to the clients, I reinforced patient education to aid in medication management and adherence.
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.
One key concept to providing quality care for a client is maintaining a therapeutic relationship. I made sure to do so as much as possible with the seniors at the Stein Center. I created lines of communication with all team members including the clients, that were respectful, reassuring, patient-centered and goal oriented to meet the needs of the clients. As a nurse in this day in age, I am aware of my cultural beliefs and I am empathic to the values of others. I utilize this skill to effectively communicate with the diverse group of seniors at the stein center.
Objective 4: Establish environment conducive to learning and use a plan for learners based on evidence-based practice.
My peers and I conducted a survey in the beginning of the semester to find out what topic the seniors wanted to learn about. The options given to them where four morbidity’s that their community particularly sufferers from. From that survey, the main topic of cancer was chosen. Throughout the next few weeks I constructed and conducted presentations on cancer awareness, nutrition to aid in preventing cancer, cancer prevention, and resources. The presentations were presented in the form of jeopardy games. The seniors really enjoyed each game. These games not only educated them on cancer but it allowed them to get active through dancing. The games even had pop culture sections that had information about music, and iconic people form the 50’s. We gave out nutritious items and pamphlets to the seniors. They not only loved the fact that they had fun, but that they left with prizes and reading material they could take home. The seniors were very appreciative for everything we had done for them throughout the semester. This made me fulfilled and it also helped validate my reasons for being a nurse and a patient advocate.
Objective 5: Utilize informational technology when managing individual and families in the community
Managing information and communication technologies to promote the health of a community is becoming vital in nursing today. My peers and I researched online using reliable data bases and sources, such as the use of community health profiles from the NYSDOH website. My peers and I broke up into two small groups and conducted windshield surveys of the community. Our purpose was to see the community for ourselves and identify any issues that the community may have. We considered everything from safety of the community to access of resources. We even spoke to people outside as well as the seniors at the stein Center to help gather information. Confidentiality was maintained as per HIPAA regulation throughout this whole experience.
Objective 6. Demonstrate a commitment to professional development
Continuing ones’ education is vital in the field of nursing. To provide quality care and services a nurse must know what is relevant today not yesterday, as the medical field is forever changing. Nurses must think critically and use evidence based practice when providing care. Demonstrating a commitment to professional development, we utilized reliable resources to conduct our research. Our community textbook was used to aid in the implementation of our interventions. In pre-and post-conference we talked about our experiences and even went on to evaluate ourselves. For example, one thing I self- evaluated was how I conducted myself when helping a vision impaired individual eat their lunch. One thing I noticed about myself was that I remembered my nursing basics. Without thinking twice I laid out the clients food and utilized the clock-face method to let them know where each item was on the table. Every clinical experience was an opportunity to adjust to the challenges presented to us as community health nurses.
Objective 7. Incorporate professional nursing standards and accountability into practice
As a nurse, I embody the American Nurses Association standards in clinical practice by providing high standards of nursing care. I promote safety and an ethical work environment while advocating on health care issues that affects the community and my fellow nurses. At clinical I practiced under my professor’s supervision while abiding by the stein centers guidelines. I took accountability for my actions at the clinical site. I was clear about my professional role responsibilities and organizational goals. When constructing the jeopardy games, I provided clear directions about how this should be accomplished and my expectations of the team. I now realize that I helped in building a culture of accountability with my peers and professor.
Objective 8. Collaborate with clients, significant support persons and members of the health care team
Each clinical day we had conferences, with the purpose of collaborating to address the clients care. This helped my peers and I to meet the needs of the seniors. Upon getting high blood pressure result, we took that time to teach the client about nutrition, exercise and the importance of sticking to their medication regime as per their doctor’s orders. Educational material and additional resources was also provided to the seniors to take home, read and hopefully utilize to better their overall well-being.
Objective 9. Recognize the impact of economic, political, social and demographic forces that affect the delivery of health care services
After conducting a windshield survey and talking to the seniors, we began to recognize the impact finances, social demographics and how it affects their health. Many of the seniors attend the Stein Center to receive a nutritious meal for a very low price. The community in which they live is rather expensive and the stein center provides services for them that they may not have received otherwise. Some of the seniors have lost a loved one or two and uses the stein center to cultivate friendly relationships. Through the center the seniors can get a workout, participate in hobby like activities, referral services and a great meal all under one roof.
Conclusion
In conclusion, my clinical experience has given me a new-found appreciation on aging. This community experience was very fulfilling and opened my eyes to community health nursing. This experience has improved my knowledge on economic, political, social and demographic forces that affect my very own delivery of health care services. This is an experience one cannot receive in the hospital setting. From here on out I will use what I learned and take it into consideration when I am preforming as nurse in all health care settings. I can honestly say that with the help of my peers and instructor, I was able to help the seniors at the Stein Center improve their health and wellness.
