Community Health Nursing: Self-Reflection Narrative


Self Reflection for Community Health Nursing


Community health nursing focus on health promotion, disease prevention and maintenance of  health. The foundation of community-base nursing is evidence-based care.Information about the concerns, conditions and strengths of  the populations and the community are gathered through community assessment which are then analyzed and identified. Community assets and their accessibility are also identified. Diversity in cultural, ethnic, economic, educational, linguistic, medical, physical, and social are recognized during the community assessment. I have the opportunity to practice as a community health nurse at the Stein Senior Center. This is a very interesting clinical experience because I was able to work with seniors not a critical or illness level. I learn to see and know what activity and program they are interested in during their leisure time when they relatively healthy. As mentioned in the beginning of the paragraph, community health nursing is able health promotion, disease prevention and maintenance of health, my clinical group conducted a health fair event beneficial to the seniors at the Stein Senior Center. Following are the objectives that I have met during the participation as a community health nurse at the Stein Senior Center.


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

Maintaining client confidentiality is part of demonstrations of individual professionalism. I’m obligated to all information shared with me by the seniors confidential unless it causes harm to the persons. Individual professionalism also involves dressing professional to the work setting. I dress in business casual and wear sneaker to the clinical as per the request of the facility. This is not a hospital setting that requires scrub or lab coat. I dress who I represent, a nurse. Punctuality is important part of individual professionalism. It is also a respect to the facility as well as to the seniors. We as a class met with Robert F. Doxsey, the Deputy Director of the Stein Senior Center, every morning and discussed the upcoming events and changes at the center. The mission of the center is “to cultivate friendly relations among the members of the Stein Senior Center and the general public; the provide services with an emphasis on group growth; to share the strengths, and wisdom of senior citizens; and referral services, and to safeguard the health and wellness of senior citizens”. I assumed responsibility for my own learning by reading the materials, information, textbooks and nursing journals that help me prepare and practice better as the community health nurse. I completed all assignments given by the professor which further enhanced my learning. My professor was always available and provided me guidance.

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

Analytical reasoning and critical thinking skills are important when providing care to clients. Analytical reasoning involves analyzing a situation, being able to look through the problem and think in a multi-dimensional way of the situation. Critical thinking is the objective analysis and evaluation of a situation with the intention to form a judgment or solution to the situation. There wasn’t much opportunity for hands on experience at the senior center. There was neither medical record for the seniors attended the center. Client information was collected through interview and information shared with by the seniors. I have done blood pressure screening. I was pleased to know that most of the seniors check their blood pressure at home regularly. They know what their normal blood pressure reading is and their medications for treating their hypertension. There was no opportunity to administer medications or treatments to the seniors: however, I assessed and reviewed the medications with the seniors. I emphasized to the seniors the indications and importance to adhere to their medication regimen. I also advised them not to stop taking any medication without notifying their care providers.

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.

Therapeutic communication involves using broad opening statements, reflecting, sharing observations, acknowledging the seniors feelings, using silence, giving information, clarifying, verbalizing implied thoughts and feelings, exploring, presenting reality and validating. When approaching and interacting with the seniors at the center, I always greet them with a smile. I always introduce my name and profession to them. I have effectively communicated with the seniors by sharing, clarifying and validating their knowledge of health. Seniors may not process the information given to them at the same speed that they used to be; therefore, I talk to the seniors at the speed that they can follow. Paying attention to senior’s nonverbal cues is also important. I have met couple of the Asian seniors at the center. I approached to them and learned that they speak Chinese and limited English. I started interviewing them using their primary language. The seniors were very pleased that they have someone speak their language at the center. They were more opened up and willing to share their thoughts and concerns.

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

We have established environment conducive to learning for the seniors. During the health fair event, there were many health care providers participated and engaged in screening the seniors. The event provided the opportunity for the seniors to consult these health care providers with the questions that they have. Brochures containing health information were distributed to the seniors. The seniors were advised and referred to follow up with the health care providers as needed. During blood pressure screening, one to one learning opportunity was provided. Seniors are encouraged to ask questions that they may have. Medications and indications of the medications are reviewed with the seniors.

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

The center has computer lab for seniors to use which they can have access to internet and vital information. We also used the computers to do community research to prepare for the health fair event that we coordinated at the center. We used the computer to communicate with vendors, to create flyers, and to print out invitation letters to the vendor. Since this is a senior center, there is no electronical medical records of the members. Yet, all information shared with me by the seniors was kept confidential. I did not disclose information about the seniors to anyone else in or outside of the center. I would only disclose information if it would cause a health concern on the seniors.

Objective 6: Demonstrate a commitment to professional development.

To demonstrate the commitment to professional development, I completed all the required written assignments which enhanced my learning experience. I reflected upon my clinical experience with my classmates on my weekly blog. When caring for the seniors at the center,  I always keep aware of my own cultural beliefs and values that vary from the seniors. Professional development also include using appropriate current literature in planning care. To assume responsibility for lifelong learning as a health profession, I must stay informed of evidence based practice to support my clinical practice through reading and researching.

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

As a nurse, it is crucial to know and remember my nursing scope of practice and nursing code of ethics. It is important to check with American Nurse Association Standards to learn and update the professional nursing standards in clinical practice. The standards of professional nursing practice include assessing, diagnosing, planning, implementing and evaluating in a patient care. Ethical practice is pertinent in provide nursing care. According to the code of ethic in nusring, nurses have the duty to advocate for equitable care for their clients, Nurses have the obligation to keep client confidentiality within legal and regulatory parameters. Nurses also have to deliver care in a manner that preserves and protects client’s autonomy, dignity, rights, values and beliefs. Lastly , nurses should know and aware of the assigned agency’s mission. As I mentioned earlier in this self reflection, the mission of the Stein Senior Center is to “cultivate friendly relations among the members of the Stein Senior Center and the general public; the provide services with an emphasis on group growth; to share the strengths, and wisdom of senior citizens; and referral services, and to safeguard the health and wellness of senior citizens.”

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

My clinical group set up, planned, coordinated and carried out a health fair event for the senior citizens at the Stein Senior Center. The staffs and the deputy director at the center were very helpful by giving us the contact list of the potential vendors. Works were disseminated among the group. We have created our own flyer of the event to the vendors and the members in the community. We were responsible for calling and emailing the invitation letter to all the vendors. We were also responsible for confirming the date with them. We also went out to the community and asked for donations to the seniors at the center. The community members were very nice and supportive to the event. On the day of the health fair, we set up the tables, table cloths, balloons and signs. We directed the seniors to each vendor and made sure that they visited all the vendors for needed health information. There were hearing screening, blood pressure screening, dental screening and many other more screenings at the health fair that the seniors could take advantage of.

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

The impact of economic, political, social and demographic forces that affect the delivery of health care services were recognized in the research of the community. Through research, my clinical group has identified the major health problems that were needed in the community include but no limited to cancer, hypertension, diabetes mellitus, cardiovascular disease and Alzheimer’s Disease. I have recognized that not all seniors are insured or are under insured. There are many services are denied by insurances that used to cover. This is the gap in care system where seniors failed to receive needed care due to noncoverage. Many insurance companies such as Health First, BlueCross BlueShield and VNS were present at the health fair event to answer questions and provide details of the insurance coverage. Health educational information and brochures were provided and distributed to the senior citizens as well. We advocated for our members who need additional resources and helps they need in order to assist them in the delivery of health care services.

I have a wonderful opportunity to practice as a community health nurse at the Stein Senior Center. The service learning project has broaden my knowledge and clinical experience at a different level of care where clients are stable, active and relatively healthy. Community health nursing is evidence based practice care that focus on health promotion, disease prevention and maintain a healthy living. Community health nursing involve assessment of a community, diagnosis of needs in the community, planning how to increase health awareness in the community, implementing of the plan and evaluating the outcome of the plan. Professional nursing standards apply in all settings with the emphasis on keeping client confidentiality, advocating equitable healthcare to clients, and deliver care to clients in manner to preserve and protect client’s autonomy, dignity, rights, cultural values and beliefs.