For my community clinical, I was placed at the Laboure Center in South Boston where I spent half of my spring semester providing home care services and the other half working alongside an elementary school nurse who cared for the students at two local schools. When I had previously filled out my preferences of the many different community placements that were offered prior to the start of my senior year, I had absolutely no interest in home care but much to my surprise, it is something that I have grown to love and appreciate. In comparison to the relatively fast paced environment of nursing in a hospital, home care nursing in the community setting is much slower and the pace is determined by the patients, who are being seen in their homes at times that usually work best for them.

Home care nursing has allowed me to gain skills in surveying homes for anything potentially harmful to the safety of patients and has increased my confidence in my ability to provide education. Many of the patients I encountered had  diabetes and hypertension. These patients often needed education reinforcement in regards to disease management, such as learning how to recognize signs and symptoms of hypoglycemia for diabetics, and making appropriate diet choices.

Although I spent a lot of time on assessments and patient education, I really enjoyed talking to the patients and learning about them and their families, especially those that have lived in South Boston for as long as they could remember. It also allowed me to become more aware of the many barriers that kept them from living healthy and high quality lives. I personally became interested in exploring nutrition since I believe that some of the patients I saw could be at risk for malnutrition. Therefore, I felt that it was important for me to work on developing a teaching tool that focused on special diet considerations for people living with hypertension, diabetes, and congestive heart failure, which I found to be common diseases among the home care population that I encountered.  While writing this teaching tool, my goal was to provide people and their families with basic information about nutrition in a simple language, such as  learning the differences in nutritional needs that occur with age and learning how to read nutrition facts labels on the back of various food products.

In comparison to my experience in home care, school nursing gave me the opportunity to focus on the health and learning needs of growing children. I was amazed to see the various resources available to ensure that all of the students receive vision and hearing screenings, as well as dental services for those who qualified for MassHealth insurance. Since the school nurse I worked with was responsible for so many students and had to divide her work day between two schools, many outside health care providers, such as dentists, optometry students and professors, and school faculty were involved in promoting the health and welfare of urban students.

By being placed at this site, I was able to learn how essential home care and school nursing is to the community, which is where people spend their lives—not the hospital. I hope to one day return to the community setting and work to promote health and manage diseases so that more people can remain in the community instead of having to experience a number of preventable hospitalizations. I strongly believe that a focus on community health will be the key to positive healthcare outcomes of Americans in the future. By devoting more time to health care on the community level, it is possible for America to reduce the significant amount of money spent on treatments for disease exacerbation.

Click here to see Selina’s PowerPoint Presentation

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