Self- Reflection

 

My clinical site this semester for the Community class took place at First Steps, located in Brownsville. It is an early education school that serves 58 families and their children from birth to five. It consists of eight classrooms and twenty-five educators with their supporters

Narrative Self Reflection:

Describe how clinical objectives were met:

Objective 1: demonstrates individual professionalism through personal behaviors and appearance

It is of an extreme importance for RN students to look and act professionally. Our clinical professor stressed the fact of being professional many times in the beginning of the semester. We had to wear nursing scrubs and our ID badges at all times while being in the facility. It is also essential to be at the location on time. It may require some organizational skills where I had to organize my time appropriately beforehand. Being punctual also reflects on turning home assignments on time before the deadline and I tried to be on top of it throughout my schooling. Teamwork is also a big part of the professional appearance, and I am very grateful to have an amazing partner Diana who helped me plan each of our visits to First Steps ahead of time. We were organized, planned our presentations and interventions ahead of time and were in a close contact with the teachers to address issues that were a part of the school program.

Objective 2: employ analytical reasoning and critical thinking skills when providing care to individuals and families in the community settings

While providing care in the community setting, a nurse has to utilize critical thinking skills and analytical thinking in order to provide high quality care. It is required to find the most optimal solution to resolve a problem. Many families in Brownsville live below the poverty level line and it is our responsibility to address their issues without stigma being attached. Since Brownsville residents are a vulnerable population with many social problems attached to their socioeconomic status, they require a special approach based on the presented problem. For example, we have one boy in our 5-year-old group who has difficulty listening directions and exhibits behavior of seeking attention, so together with the teachers we implement Positive Behavior Intervention Support. It is a program that promotes positive behavior and works to improve children’s academic performance, safety, address problem behavior and establish positive school cultures. So, through reinforcing and awarding good behavior children overall behavioral performance gets improved.

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

We had to utilize age appropriate communicating skills with the children in school. Diana and I were in a 4-5 year old group, so our job was to approach children according to their age. Children are very open and loving and it was our job not to betray their trust, but promote trusting and therapeutic relationship. We have to talk clearly, slowly giving children appropriate time to express themselves. We utilized different strategies to improve communication, such as Power Point presentation on the most important topics in the area. Also, we did a cooking activity with the children, where not only we engaged them in a group process improving their social skills but also learned different shapes of vegetables which promotes learning of what was covered in class that week.

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

Conductive environment is very important for the successful learning process. Members of First Steps provided us with the hall space where it would be easy to invite people in for participation in our presentations and teaching processes. The room where we spent our time with the students was well lit, quite and warm. So the environment was very comfortable and promoted learning. We also created a poster with a group picture so that the parents knew who we are and what we were doing at the school. Our group was divided into subgroups that worked on their smaller presentation including teaching plan. All of us incorporated EBP into our teaching plans. The topics we discussed with community residents were vaccinations, nutrition and emergency preparedness, which by statistic are the most important topics that had to be covered.

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

We did not use the principle of nursing informatics at the clinical site, but we had to research information for our presentations on the Internet either from school or from home, we also had to use either text messaging or school emails to stay in touch for our group projects, we also used printers for fliers that were passed to the parents after each presentation.

Objective 6: demonstrate a commitment to professional development

Before coming to the clinical site our professor would make us read articles on child development, on the Brownsville community, and how poverty affects child development. On my own, I viewed a couple of videos on age appropriate games for our 5 year old group, how to keep children engaged while teaching them some social skills incorporated in PBIS, being respectful, responsible and safe. I think that being a RN is a life long learning process with a continuous self-evaluation. In Brownsville I had to adjust to work effectively with a vulnerable population at Brownsville. We had to understand and recognize residents’ needs, plan and implement teaching plans, based on evaluation of those needs.

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

The school’s mission is to improve outcomes for children and their families by advancing quality and best practice in early education settings. They are doing this through art classes, and creative playground activities to reinforce child parent bonding. In addition, teachers provide parents with knowledge and tools that will help them advocate for their kids in the future. The ANA standards state that “RNs are prepared to consistently practice safely, compassionately, competently and ethically in diverse practice settings, with a variety of clients at different levels throughout the continuum of health and illness”. We utilized these standards at our clinical site, providing high quality care mentioned in the school’s mission and in the ANA standards’ list.

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

Nurses have to collaborate, work with each other or others cooperatively. We had to collaborate with the two teachers in our classroom, and find best ways to incorporate what was learned in school that week with our RN interventions. For example, one week we had to cook with the children, and in order to promote healthy eating habits, I and my partner Diana, decided to incorporate vegetables in a group game. So, the teachers asked us to cut the vegetables into geometric shapes to promote learning while incorporating healthy eating habits. Children had a chance to try vegetables with a raspberry dressing, while defining shapes. So we collaborated effectively wit the teachers, children and their parents. All of our interventions were discussed and approved before implementation stage.

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

Nurses can play a vital role in improving health of individuals, families and a community. They act as advocates, as well as they have a power to allocate proper resources to improve health and wellbeing of the community members.

Unfortunately healthcare system has many gaps that still need to be addressed. Healthcare has to be accessible, affordable and high quality. And while in the US the quality of care is improving, the educational level rises for entry nurses, the affordability and access problems are not as well addressed. For instance, there are no asthma specialists in the area, which makes it harder for the parents to keep asthma problem under control. And besides our group preparing the presentation on asthma action plan, I strongly believe there should be more specialists in the area. Due to socio-economic problems, the Brownsville community is underserved.