Community Health Nursing Clinical Experiences - Coursework Example

Community Health Nursing Clinical Experiences Community Health Nursing Clinical Experiences Introduction With the growing population of elderly people, the role of community health nurse has evolved to incorporate evidence-based skills in mental care. I gained valuable nursing experience in community health while attached to the ARC of Prince’s George County in Maryland. Working with adult clients presenting with intellectual and developmental disabilities provided new insights about the way I want my career to progress and what I need to in terms of skills, knowledge and competencies required for success in this area. This paper gives a personal reflection about nursing community health clinical experiences within the stated behaviors in each of the eight objectives. In particular, the paper examines reflection of the specific clinical experiences, conversations, perceptions and new understanding. Reflection on Clinical Experiences Objective I: Demonstrates caring nursing behaviors and safe, competent skills in community health settings for individuals, families, groups, and whole communities (all defined as “client”) across the health-illness continuum Behaviors: 1. Demonstrates awareness of and sensitivity to differences in cultures, values, races, religions, gender, lifestyle, age and sexual orientation A critical analysis of the clinical experiences in community health reveals that nurses working in this particular area of care must demonstrate awareness of and respect to patient differences, preferences, values and uniquely expressed needs. In practice, I learnt that a professional caregiver meets patients from diverse backgrounds. I learnt that application of sensitivity to these issues could help one improve patient and treatment outcomes. For instance, in my encounter, I met patients from diverse cultural background. One patient stated, “…I have to fast, this requires Godly intervention’. This comment revealed how cultural barriers, especially those related to religious beliefs could affect care giving. 2. Protects the privacy of all clients and preserves the confidentiality of clients and health care providers My experience in the community nursing practice provided insights about the issue of privacy protection among other important issues concerned with confidentiality. I learnt that professional care givers working in community programs must demonstrate very high competence in addressing privacy issues. For instance, one patient with terminal disease appeared to withhold vital information about the clinical history of the disease. Upon further investigation, I established that she was uncomfortable if such details reached her husband. I convinced her about the confidentiality requirements and advised accordingly. This experience raised my awareness about legal and ethical issues of privacy and confidentiality of patient records. 3. Designs care with a sensitivity to the unique needs of the client(s) in a variety of settings One of the most striking issues in the community practice was the socioeconomic disparities. For instance, I met patients who could not afford certain medications or necessary medical procedures. I learnt that working with these patients requires one to have relevant skills and knowledge. For instance, I advised patients about the various strategies they could use to fund for their health and medical needs. The impact of this has been overwhelming with many of the patients now able to cater for their own medical bills. Objective II: Interprets and integrates the philosophy of the nursing program with respect to person, health, environment, and nursing in community health practice settings Behaviors: 1. Demonstrates understanding of the interrelationship between clients, family and communities. An important issue that arose in many of the cases was the issue of family support. This relates to the concept of family-centered care, an approach that formalizes patient’s family as an integral unit of care. Although I had learnt the importance of family support in theory, this practical experience brought new meaning and understanding of family support. Now I know how to create collaboration and partnership from family members through practice based on mutual respect, confidentiality and support. In particular, I leant that partnering with family members for patients improves the support and overall outcomes. 2. Demonstrates understanding of the interrelationship of the personal, social and physical dimensions when caring for clients in community health settings From theory, I had learnt the role of comprehensive care integrating personal, physical and social elements. However, the community practice helped in developing practical skills for offering person-centered care. For instance, I recognized the individuality of patients as well as the personal, social and environmental factors that had bearing on outcomes. This strategy provided a holistic approach to addressing patient health care problems. It also enabled me to understand patients better given their unique backgrounds and health needs. 3. Uses nursing diagnoses that reflect the philosophy and organizing framework with respect to the clients in community health nursing settings. My experiences in ARC brought new ideas on how to approach the needs of older adults with IDD. I learnt that there is a general tendency to ignore or overlook signs and symptoms of IDD, especially in older adults. This could be attributed to lack of knowledge and health care disparities that result to late diagnosis of the condition as well as poor treatment outcomes. Objective III: Integrates and demonstrates a variety of nursing roles and related professional competencies for community health practice with respect to the nurse as care planner/designer, provider and coordinator of care 1. Demonstrates the role of partner in the planning and designing of care in the community health setting In the role of care provider, the community practice helped in understanding how the nursing process helps practitioners to make clinical decisions. I did not appreciate the components of nursing practice before this practice. Upon undertaking the activities, I learnt the role of providers and the various components including assessment, evaluation, planning and implementation. 2. Demonstrates the role of provider of care in the community health setting In the community practice, it occurred to me that the role of care provider relies on the establishment of trusting relationships that enable them to link patients and health care facilities. First, the care givers must build both community and individual capacity by way of increasing knowledge via advocacy and social support. I also learnt the role of informal counseling and community education, especially when dealing with adults with IDD. 3. Describes the use of appropriate roles when caring for clients in a variety of community health settings. An interesting feature about the community practice was the issue of appropriate roles given the diversity of community health settings. My experience shows that community health workers must be prepared and dedicated to function across a continuum of diverse health setting. My roles varied from one location to another even within this community. This is especially important because patients expressed unique health needs and exhibited different perceptions based on cultural underpinnings. In all the communities, my role was to help develop systems that are culturally appropriate and relevant to individuals. Objective IV: Demonstrates competencies in critical thinking skills leading to evidenced based reasoning and decision-making, independent thinking, scholarly inquiry and creativity in the provision of care for individuals, families, groups and whole communities 1. Demonstrates knowledge and skill in biotechnology and information technology to integrate theory and research into practice One of the lessons learnt in the community practice was the importance of technology in community work. Initially, I faced significant challenges in keeping accurate and updated records. I learnt how to use cell phone software to update records conveniently. I transfer these records to the register once I complete my rounds. This has made my job more convenient. 2. Analyzes care provided by other professionals and makes recommendations for changes A careful personal refection of the community practice shows the importance safety and quality improvement in care. This concerns continuous assessment of patients to ensure that interventions remain appropriate and effective. For instance, I would send patients for further clinical investigations with laboratory and or radiology professionals. I would then use results from various professionals to adjust interventions. This helped develop knowledge about comprehensive care. 3. Client outcomes are prioritized and are mutually determined, realistic and measurable Another important issue that arose from the community practice is the issue of patient-centered approach. I learnt how to use comprehensive assessment using processes that are sensitive to age, cultural issues, gender and disabilities. I also learnt how to examine lifestyle issues as well as emotional and psychological issues. Objective V: Comprehends and demonstrates ethical and legal responsibility and accountability for learning, professional nursing behavior, and caring practice embodying human values of altruism and social justice 1. Produces clear, accurate and relevant writing to analyze and synthesize information and experiences After the community practice, I learnt that the application of the four elements of nursing planning in community care. The most applicable elements in my case were documenting, establishing priorities, goal setting and planning interventions. 2. Continually assesses one’s own learning needs and identifies strategies to address these needs I also identified a number of areas that I need to improve knowledge in. The first area as when a patient requires more than one intervention. I want to develop more knowledge on how to prioritize nursing diagnosis given patients desires, safety and basic needs. I plan to continue with this practice and further education in this area. 3. Demonstrates timeliness in clinical work and written assignments The community practice provides important insights about the tight schedules for completing clinical work. It emerged that that comminute nurses must not only focus on delivering quality care but also demonstrate the ability to meet those tight schedules. This is particularly important given that timeliness determines patient outcomes as well as learning achievement on the part of the student nurse. Objective VI: Utilizing holistic, reflective, and professional nursing and leadership skills informed by the arts, sciences and humanities, demonstrates concepts of health promotion, disease prevention, health maintenance, and health restoration for individuals, families, groups and whole communities Behavior: 1. Utilizes scientific principles in providing safe and competent care In the community service, I employed knowledge in developmental disorders and behavioral sciences to offer care to adults presenting with intellectual and developmental issues. 2. Describes appropriate pathophysiology and psychology in relation to specific clients From my interactions with patients, I learnt that developmental disabilities could be complicated and even some cases can have unknown etiology. This makes it possible to design prevention interventions at the community level. 3. Integrates knowledge of health promotion, disease prevention, health maintenance and health restoration in the delivery of care In my practice, I met people patients who have developmental disabilities combined with challenging behaviors that seriously limit access to ordinary facilities such a biting and hitting behaviors. I learnt about the major causes of these behaviors in this community including social and biological factors such as pain. Objective VII: Develops and demonstrates knowledge of communication theory by establishing interpersonal and therapeutic relationships with individuals, families, groups within the community health setting Behaviors: 1. Demonstrates awareness of and sensitivity to differences in cultures, values, races, religions, gender, lifestyle, age and sexual orientation In my practice, religious and cultural issues appeared to have tremendous impact on people’s perceptions about mental diseases. It was imperative to have a clear understanding of underlying cultural beliefs and values in offering support to patients. 2. Maintains privacy and confidentiality in all communication As mentioned above, there were cases when patients withheld vital information. I understood the primary concern was whether we would protect this information as nurses. I learnt how to ensure privacy via face-to-face conversations when necessary. 3. Adapts to the communication needs of the clients, staff, colleagues Working with elderly clients was particularly challenging because some spoke incoherently while others could not speak English clearly, and thus needed an interpreter. I learned how to communicate with a diverse group of people and different stakeholders. I also built some skills in sign language. Objective VIII: Analyzes and comprehends the effects of sociopolitical, cultural, legal, economic, environmental, and other global forces on community health nursing practice and the health care delivery system as related to community health settings Behavior: 1. Identifies economic issues that impact on community health settings Working in this community exposed me to the socioeconomic disparities among the people and cultural beliefs that influence lifestyles. As mentioned earlier, some people did not have health insurance cover yet they required expensive medical care. I offered advice and connected them to appropriate institutions. 2. Identifies ethical issues faced by clients within community health settings There were many moral and ethical issues faced by clients within this community. For instance, I met an elderly woman with a terminal disease, but could not disclose this information to her children because she did not know how they would react. 3. Identifies sociopolitical and cultural factors relevant to the community health settings Working with elderly people requires one to understand community values, beliefs and attitudes. I learnt this because some of the elderly patients in this community had strong beliefs mental diseases. Although I expected this, I would not imagine such strong association between witchcraft and developmental disabilities. Read More