Running head: PRE-ACTIVITY REFLECTION

Pre-Activity Reflection
Vera Nixon
Bon Secours Memorial School of Nursing
Vulnerable Populations and Global Health Practicum
NUR 4215P
Ms. Robin Nasi
August 28, 2016
Honor Code, I pledge
Pre-Activity Reflection
This purpose of this paper is to reflect on my upcoming practicum, including
expectations, my strengths and weaknesses, expected barriers, biases, and challenges, and what I
may learn from my experiences. My practicum will be taking place at the Goochland Free
Clinic.
Self-Assessment
Expectations
In this practicum, I hope to learn more from what is experienced and expected from an
outpatient standpoint. My entire nursing career, including my position as a patient care tech, has

been involved in the hospital setting, entirely on the general pediatric floor. While I have
received some pediatric emergency room experience when being pulled down there while they
are short staffed, my experience is completely limited to the inpatient setting. Working in the
inpatient setting, specifically on weekend nights, I am limited to my interaction with other
members of my healthcare team, so I am largely unware of uninsured/insured ratios of my
patient, as they are treated similarly. I do not often assist with discharge set-up or follow-up, as a
night-shift nurse, so I typically offer resources or the help of the care manager during admission,
when I typically directly ask questions related to concerns of insurance or outpatient resources.
I truly hope to learn more about the difficulties facing most individuals in response to
healthcare issues in their daily lives. I am aware that I see a small window in the hospital setting,
and oftentimes have difficulty relating their hospital stay to what they may expect once
discharged, due to the fact that I simply do not know. I hope to be able to take what I have
learned and apply it to my current patient population within the hospital in order to be more
aware of the resources and availabilities of assistance.
Stereotypes and Biases
In anticipation of working with a free clinic located in a rural area, I am cognizant of
some biases and stereotypes that I may have. The demographics of Goochland County
demonstrate a vast majority of Caucasian individuals, well over half being between 18 and 65,
equally divided among men and women, mostly with a high school diploma and a smaller
percentage with a bachelors degree or higher, with only 6.6% under 65 without insurance, and a
median income of $82,460 (United States Census Bureau, 2015).
The fact that I felt surprised by most of this information showed me where my biases
lied. I expected a higher elderly population, with lower income, more uninsured individuals,

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with less formal education. This has caused me to realize that my local experience of Goochland
County has influenced my opinion. The area in which I live in Goochland County is very rural
and isolated to a specific demographic. Most of my neighbors are past retirement, and what most
would consider very country with heavy country accents and an overall laid back and
sometimes disheveled appearance, as well as being on a limited and mostly lower income. I
expected this to be the norm for this county. The census reports do not demonstrate that, as
Goochland County encompasses a large area, including some higher income areas as well, which
may be off-setting the census reports (United States Census Bureau, 2015).
Strengths
In regards to strengths I feel that I provide compassionate and empathetic care, no matter
the circumstances. I also am stronger in areas such as adaptability, encouraging harmony, and
attempting to deal with issues in a positive way (Rath & Conchie, 2008). I tend to adapt to the
situation, allowing for thinking outside the box, as I am often charge nurse on my weekend night
program, which typically has limited resources. I hope to bring that resourcefulness to this
practicum. I also hope that my strength in positively responding to difficult tasks with positive
outcomes (Rath & Conchie, 2008) will lend to a positive practicum experience.
Servant Leadership & Professionalism
Within this practicum, I hope to apply the experience and knowledge I have gained of
active listening and professionalism can assist me throughout the experience. Applying the
concepts of identifying non-verbal communication with what the patient is saying and creating
an open conversation with the patient can help to develop a relationship of trust (Kumar, 2010).
Furthermore, taking my experiences of professionalism and recognizing my limitations and
biases without acting on them, can further foster the trust in a nurse-patient relationship (Kumar,

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2010). While I tend to feel less confident when I am out of my element, I hope that relying more
on what I know, and applying it to this new experience, I will be able to learn from this
practicum.
The issue that I am concerned with is the fact that I am essentially a stranger to all that
will be entering the clinic. In my dealings with this area after moving here, I recognize that trust
is slowly built and developed, the longer you have interactions with individuals. As I will only
be at the clinic for a short time, I recognize that a certain level of mistrust is to be expected. I
know that I will need to rely on the fact that individuals tend to have a certain level of trust for
medical professionals, in that they are voluntarily coming in to be treated, and therefore will
need to try and work of that patient-nurse relationship.
Growth
While in this practicum, I hope to learn how individuals truly maneuver through the
outpatient healthcare system. I anticipate learning of the resources available in this community,
and hope to bring it back to my workplace, where oftentimes I have individuals from the
Goochland area. I also anticipate working with more of the older pediatric population, as
typically in the hospital, babies, toddlers, and school-aged children tend to be admitted. I also do
not tend to be able to discuss and do education often in the hospital setting, working the night
shift. I hope to practice and refine my education skill within this practicum.

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5
References

Kumar, K. (2010, January-March). A new culture of leadership: service over self. JCN, 27(1),
46-50.
Rath, T., & Conchie, B. (2008). Strengths based leadership: Great leaders, teams, and why
people follow. New York, NY: Gallup Press.
United States Census Bureau. (2015). State & county quickfacts: Goochland County, Virginia.
Retrieved from http://www.census.gov/quickfacts/table/PST045215/51075,00