NARRATIVE SELF REFLECTION OF LEARNING PROJECT

My name is Vayola Jean, and I am one of the nurses currently working at Shore Hill Senior Housing for the duration of the fourteen week clinical Program. My clinical rotation is every Wednesday from 8:30AM to 12:40PM. Shore Hill Senior Housing, located at 9000 Shore Road, Brooklyn, NY 11209, is in the Community of Bay Ridge. The building itself is 14 stories tall, containing 276 apartments ( 20 per floor) with a total of 550 residents. Having finished eleven weeks, there are a number of moments and experiences that I want to discuss and reflect upon throughout this paper. I was able to achieve my clinical objectives in collaboration with my clinical instructor, my colleagues, the staff at Shore Hill and particularly with several residents at this center.

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

During my clinical rotation at Shore Hill,   I maintained client confidentiality by writing only the clients’ initials and keeping all interviews private. I attended the clinical punctually in accordance with school and facility policies. I completed my assignments on time and participated actively in different Shore Hill activities.

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

During the eleven weeks , I visited four seniors in their apartments and developed a connection with each of them. I interviewed them and had a referral form provided by staff at the housing containing information regarding each of the residents. When visiting, I completed assessments of the resident’s health status and the environment. The impact of developmental, emotional, cultural, religious and spiritual influences on resident’s health were addressed. Most of residents at the housing have a home attendant to help them clean and prepare food but one of the seniors had no home attendant and appeared confused and forgetful. I voiced my concerns to the Director of the program that it was not safe to leave her alone. I also reported my observations to my clinical instructor to follow-up with the person in charge. Although I did not have to administer medication, I still reviewed the medications they were taking, asked questions about their medications, reinforced how important it is to take their medications regularly and if any side effects became apparent that they should report it to their primary doctors or to the visiting nurse.

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.

I utilize therapeutic communication skills with seniors in the community to address their health care problems. My usual routine every Wednesday is to check blood pressure in the Dayroom for at least one hour. At that time, I have the opportunity to interact with the elders in an one-on-one setting. They are between 65-95 years old, and about half of this population are Chinese folks who struggle to speak English, presenting a language barrier for communication. But I continue to patiently provide instructions as necessary, taking into account this language barrier.

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

At Shore Hill Housing, the Dayroom environment was comfortable for the residents and was appropriate for the different activities that took place such as exercise, Bingo, and playing cards. They also use the same area to listen to the presentations planned by many groups like the Nurses from New York City Tech and Nurses from other universities as well. The subjects of these presentations are the following: Nutrition, Breast Health, Fall Prevention and Smoking. PreTest and PostTest questions were given to evaluate the seniors learning outcome. The results in PostTest demonstrated improvement and understanding of the information provided.

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

The residents’ privacy and confidentiality were protected at all times when using their record. Information provided during assessment in home visits about their health or their finances were kept anonymous when blog assignments were posted on Blackboard.

Objective 6: Demonstrate a commitment to professional development.

I used appropriate literature in planning care for the residents at Shore Hill. I did research about the community by using electronic sources. I assume responsibility for lifelong learning. I take it upon myself as a commitment to adjust to the challenges of independent practice in Community Health Nursing.

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

I complied with the Housing Standard of Practice and was accountable for my actions in the clinical area. I was aware of the Lutheran Family Health Centers ‘s mission. I also followed the standards in clinical practice implemented by the American Nurses Association.

 

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

My team and I collaborate at all times and effectively with other members of the facility as one health care team to address the clients’ problems. One of the major problems in this community is the language barrier.   As an immigrant myself, I understand their frustrations and try my best to use non verbal communication techniques, and show them understanding, empathy and compassion. Sometimes, I seek out the help of an interpreter when I have some Blood Pressure readings out of range or if I want to ask residents about their medications. We provided them information about healthy life styles, educational materials distributed and referral to government agencies and identified health care resources .

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

Recognition of gaps in care system in the community is very complex. Identifying some of the problems and finding solutions is very difficult. We can start by educating the seniors about their rights, providing information on Medicaid, Medicare, Housing and Health Resources. Acting as change agent to advocate for client is very important in Nursing.

Summary

The clinical rotation at Shore Hill was beneficial when planning and implementing the four health presentations. The residents participated actively and were willing to share their personal experiences. At times, I felt like I was learning more from them than they were learning from us. By teaching and preparing the materials, I had the opportunity to reflect on my own personal habits and behaviors, and I tried to change what I could. I realize after talking to some of the seniors that they face serious financial challenges without family or community support. As a Community Health Nurse, it is my obligation to be their voice, to obtain petitions signed by the community and to present policies to the council for the concerns and problems of these residents to be addressed.