Clinical Experience Paper

For my clinical experience today I shadowed an RN, at the Ashe County Health Department. The RN was participating in the flu clinic today. She administered many flu vaccinations. Most of the individuals that came in today for the clinic were over the age of 65 and were given the high dose flu vaccination. The RN also worked with a Spanish interpreter during several visits throughout the day. She would first assess a Spanish speaking individual’s ability to speak English, then if deemed necessary she would call for the interpreter. The nurse made sure to always direct her questions, and maintain eye contact with the patient. She wanted them to feel included, and really engage them through therapeutic communication, even though she did not speak
their language. The nurse also provided education to a patient that had been newly diagnosed with type 2 diabetes that same day. She made sure to allow him to express his feelings, and was a resource for any questions he had. The nurse educated him on diet and lifestyle changes. She worked with him to set acceptable goals, which he believed he could reach. From this experience I learned that the public health nurse working in the health department, sees a little bit of everything. There were many different cases that came in, and each patient had unique needs. The nurse was responsible for much more than just immunizations and record keeping. She worked directly with the general public meeting each patients complex needs. Assessing, educating, advocating, and referring were just some of the roles that I witnessed by the nurse. I also learned that many patients go to the health department for routine physicals. I did not know this prior to spending time there. I felt like it was a good experience. I did not like however, that they rotated me and another student from being with the nurses to going with the lab technicians. There was not much to do in the lab that day, and I did not learn much the second half of my day. The article I chose described public health nursing practice today in relation to the time-honored model by Lillian Wald.
Researchers studied and described public health nursing practice in local health departments in Connecticut. They found that there was a wide diversity in program responsibility. While the health departments studied had the same primary goals, health promotion and disease prevention, there was variable local health care delivery patterns which in turn caused a disparity in care received at different locations. In addition, the researchers identified several factors that influenced service delivery such as the aging population, growing population of handicapped persons, an increasing number of children attending daycare and the mainstreaming of special education students. Today I could see the primary goals of health promotion and disease prevention, being used in practice to better the community. The nurse educated each patient that came in, whether it be on lifestyle changes, eating habits, or needed immunizations. Furthermore, the majority of the population seen today were the elderly. It is becoming evident that more of our population is aging due to increased fertility and decreased mortality rates. The nurses at the health department made sure to modify their teaching to fit the age of the population. For example, the nurses recommended the high dose flu vaccination to those over 65. I would like to revisit this article and see how the health
departments I visit differ in delivery of services.