Академический Документы
Профессиональный Документы
Культура Документы
Kelsey Singh
October 9, 2018
“I have neither given nor received aid, other than acknowledged, on this assignment or test, nor
have I seen anyone else do so.”
SUMMATIVE SERVICE-LEARNING REFLECTION 2
experiences during my nursing training have shaped my values as a nurse. Out of high school, I
choose nursing education for two main reasons—the job market is strong for nurses and since I
second year at Old Dominion University, I faced the difficult choice of staying at ODU, which I
dilemma, the best answer for me became surprisingly clear. Bon Secours Memorial College of
Nursing and I chose each other, and my journey on a service and community-based path to
nursing began.
include focused treatment of patients’ illness. As I studied theories of nursing and more
importantly worked with real patients, I quickly learned that my treatment expectation was too
acknowledgement of the role mental health, family, and community play in a patient’s illness
and healing. Service learning became defined for me as engaging with the patient’s total
community to define the patient’s health care imperatives that shape the patient’s health care
needs.
I have learned the community in Richmond has both weaknesses and strengths. The
overarching weakness is that too many patients lack adequate access to health care. Several
factors impact access to health care. Many patients cannot afford even basic health care,
especially for chronic illness. In addition, too many patients lack sufficient health care
SUMMATIVE SERVICE-LEARNING REFLECTION 3
waiting too long for treatment. Thus, these patients present with advanced illness that is more
expensive to treat, for the patient and the health care provider. From the nurse’s perspective,
community needs caused by many reasons. These reasons include increase in chronic illnesses
such as diabetes and heart-disease, and extended life-expectancies. Other reasons include
advanced medical interventions that improve patient outcomes but require dedicated nursing
resources, such as specialized intensive care units that may have a one to one ratio of nurse to
patient, and the globalization of healthcare. This lack of nursing resources is compounded by
an increased focus and access in the nursing community to become something other than a
bedside nurse; thus, nurses are becoming Nurse Practitioners, Certified Registered Nurse
In this same Richmond community, however, I see many strengths that provide
has expanded. For example, Bon Secours recently increased its nursing program class size from
50 to 100 students. Richmond has numerous hospitals, both private and public, and they offer
robust indigent care programs that provide free or reduced fee access to acute and managed
medical care. As a state teaching hospital, VCU Health’s Virginia Coordinated Care program
provides primary and follow-up care on a free or reduced basis to qualified patients, and VCU
nurses serve in many capacities, such as as bedside nurses, case managers, and outreach
facilitators. To attract more nurses and other medical professionals, hospitals are becoming
SUMMATIVE SERVICE-LEARNING REFLECTION 4
more flexible and creative with employee-friendly options, such as on-site 24-hour childcare
Practitioners are increasingly able to work independently of doctors; while this does not help
the shortage of bedside nurses, it does facilitate increased access to affordable healthcare.
However, the greatest strength I have observed in this community is the selfless servant
attitudes that nurses and nursing students exhibit. I see nurses watching patients, not clocks;
taking time to hug and reassure family members; providing little kindnesses that do not involve
medical care, but have everything to do with healing, like brushing a patient’s hair or massaging
I am a “person of color” with a Black and East Indian heritage, who grew up in a middle-
class home with a loving extended family and full access to healthcare of all types. I believed
income often determined quality of healthcare, but I did not give much thought to access issues
until I started the nursing program at Bon Secours in 2016, about the same time Congress
began dismantling the Affordable Care Act. Through media coverage, family debates, and
classroom discussions, I realized that access issues spread across patient communities, without
regard to race, religion, citizenship, and sometimes, socioeconomic status, such as when a pre-
existing condition could cause un-insurability. I realize now how blessed and protected my life
has been, but my nursing program opened my eyes to the variety of healthcare issues that
Responding
First and foremost, I have learned that there is not a fix for every need in the
community. Also, patient engagement is requisite for a successful outcome, however that must
SUMMATIVE SERVICE-LEARNING REFLECTION 5
experiences. I have volunteered with Special Olympics of Virginia, conduced elementary school
medical screenings, and helped to organize a team from the VCU Health Cardiac Surgery ICU
(and to design the team T-shirt) for the annual Richmond HeartWalk. These service learning
activities have differing levels of relevancy to my learning experiences and to the community.
education and research. Conversely, medical screenings require hands-on contact with
community members, which has an immediate impact on the individual patient and allows me
to see how other factors influence the effectiveness of community engagement. Special
Olympics combines the best of big picture impact with one on one engagement with a
community member.
classroom concept to people. These experiences have also enlightened me to the necessity and
difficulty of funding, because without it, even selfless servants cannot provide basic healthcare.
I now realize that nursing really is a call to serve the patient and the relevant communities that
effect that patient. I also realize that I need additional understanding of policy determinations
My service learning activities took me beyond the bedside into the community to
broaden my understanding of the many imperatives that impact my ability to help a patient
heal. They have also helped me redefine what a successful outcome is, based on an assessment
with the individual patient, his community, and other medical professionals. For me, service
SUMMATIVE SERVICE-LEARNING REFLECTION 6
beyond bedside patient care is necessary to develop an understanding of the policy imperatives
that impact quality and availability of healthcare. Such experiences also increase nurses’
awareness that presenting symptoms are always influenced by community factors such as
Prior to the service learning activities noted above, my early nursing classes offered
insights into service learning. During Foundations of Nursing Scholarship (NUR 1100), I
I was exposed to policy concerns surrounding funding, education, and legislative initiatives. In
Vulnerable Populations and Global Health (NUR 3113), I visited many local care centers, where I
gained a realization that vulnerable populations identified on a global level are equally
prevalent in this immediate community. Mental Health (NUR 3114) required visits to local
mental health centers, where we discussed how appropriate interventions positively change
lives. Finally, my service activity in Metaphysical Nursing (NUR 4144) involved visits to a
children’s home, where I engaged in everyday activities with the children, such as kickball,
drawing, and coloring. During these ordinary engagements, the children would often begin to
discuss there fears, hopes, dreams, all pieces of a successful healthcare plan and outcome.
Each early experience offered a different insight into the breadth of a patient’s community and
the critical importance of continuing service learning activities, even beyond the classroom.
civic life of communities and to develop knowledge, skills, values, and motivation (Embree & Lu,
SUMMATIVE SERVICE-LEARNING REFLECTION 7
2016, p. 2). Embree & Lu state that civic engagement includes personal integrity, social
conscience, political engagement, and civic involvement (2016). From my perspective, civic
that I continue service learning activities even as I move from student to clinical nurse and
beyond. I just accepted a job offer as a clinical nurse in the VCU Health CSICU. When I
graduate, most of my efforts will be geared toward learning and achieving my job description. I
also plan to join related professional organizations like the American Nurses Association. In
addition, I will complete relevant in-service training when possible. Since VCU Health serves
such a diverse population, however, I will need to continue to build my knowledge of unique
community needs by moving beyond CSICU patient care to engage other healthcare
comprehensive plan to define and ensure a successful outcome. Embree & Yu state that
nursing civic engagement has declined similarly to the decline in general civic behavior (2016).
Thus, nurses are less engaged with “communities, government processes, and collaborative
problem solving” (Embree & Yu, 2016, p. 1). I have begun to understand the legislative role in
health care, for patient access and care, and for nurses as advocates for nursing and community
health. I will find ways, therefore, to educate myself on political processes as I continue to
workers, such as committee membership, because I have observed the value of collaborative
healthcare.
SUMMATIVE SERVICE-LEARNING REFLECTION 8
References
https://www.researchgate.net/publication/305362545_Civic_Engagement_Experiences_of_Stu
dents_Preparing_for_Roles_as_Clinical_Nurse_Specialists_Civic_Engagement
Embree, Jennifer & Lu, Yvonne. (2016). Civic Engagement Experiences of Students Preparing for
Roles as Clinical Nurse Specialists: Civic Engagement. Nursing Forum. 52. 10.1111/nuf.12170.