Praxis notes:
Community health nursing practice. Reflecting on the role of the community health nurse in emergency response:  Including natural disaster, terrorism and pandemic response.  Learning moment: after the zombie emergency preparedness activity during tutorial.

Due date:November 6  23:59 pm
Submission Type: Submitted to Moodle Turnitin and as negotiated with the Clinical Course Director (CCD).

Reflective Praxis notes are critical reflections on your community health nursing practice. They are part of your larger portfolio and may provide a vehicle for:

    Facilitating praxis (that is theory and practice informing each other);
    Critically reflecting on your attitudes and beliefs related to your practice;
    Critically reflecting on ethical, political, and/or professional issues encountered in your practice.
    Providing a window to your practice through which your Clinical Course Director (CCD) can see your work;
    Documenting your progress towards attainment of your learning goals.
    Providing you a venue to process course materials, what you are bearing witness to in your clinical setting, and your development of self as nurse.

Reflection is a deliberate and conscious activity that enables learners to think about events and their responses to these events. This activity is in both written and oral format. Reflection helps you to explore and process your experiences and gain a deeper understanding of your communitys lived experiences as well as what the practicum setting is doing to enable the health of your community. Reflection is a personal and unique way of meaning making. It is to help you make connections between classroom dialogue, readings, your past experiences, research and your emergent understanding of community health nursing in Canada.

Your praxis notes are a place to share ideas, and your Clinical Course Director (CCD) will respond back to you by asking more questions, inviting further inquiry, requesting clarification, or sharing similar questions she/he has or had. You are required to follow up on this input from your Clinical Course Director. Your response to these inquiries must be evident in subsequent praxis notes. Reflection allows you to learn in a different time and place from your immediate experience.


Praxis Notes Grading Criteria

Evidence that indicates:
    Foundational and required course materials are integrated into practice;
    Additional current and relevant research and literature is informing practice (at least 6 articles during semester);
    Practice is guided by nursing science (Watsons Theory of Human Caring, nursing research, and other nursing knowledge)
    Critical reflection on personal attitudes and beliefs related to practice;
    Critical reflection on current ethical, political, and/or professional issues in practice;
    Professional growth and self-evaluation of practice, including responsive to and a demonstrated integration of Clinical Course Directors questions/feedback;
    Professional accountability through self-directedness, appropriate consultation with preceptor and other health professionals, incorporation of feedback of course professor and preceptor, punctuality and follow through on meeting commitments.

Praxis Notes Principles

1.    What do I need to do?
Consider your community health practice each week. Select and reflect on a significant learning moment, or clinical experience. Use the literature to deepen your understanding.  Describe how these insights will inform your nursing practice as you move forward. Students may use a reflective model or framework to guide their praxis notes.

Reflecting on the role of the community health nurse in emergency response:  Including natural disaster, terrorism and pandemic response. 
Learning moment: after the zombie emergency preparedness activity during tutorial.

During tutorial we did an activity in which a zombie attack was approaching our community and 3 students were governors, 3 were health care professionals and 3 were community members and so we debated as to what we needed to do to contain the spread and to evacuate etc. After the activity I wondered about the role of a community health nurse in an emergency response.

Nurses are perceived as first receivers in a hospital setting and first responders in a public health setting. Nurses are exposed to disasters in a variety of ways during their work day. The disaster can be a mass causality incident involving several injured patients, where the hospital and the nurses exceed their capacity to respond and treat, or it can be an outbreak such as salmonella poisoning that has the hospital treating the sick patients and conducting epidemiological investigations. Both nurses and public health nurses are tasked to respond to the immediate needs of the affected population during a disaster (Keeney, 2004). A commonality among nurses and public health nurses is that during any disaster, they need to rapidly conduct an assessment to identify the priority needs of the patient or population. An exception to this is most nurses who work in a hospital environment have an identified role to play during disasters when it comes to patient care within the health care facility, versus the public health nurse who does not have a clearly defined role during disaster preparedness.

From Role of the Nurse During Disaster Preparedness: A Systematic Literature Review and Application to Public Health Nurses.


2.    How long should my written Reflective Praxis Notes be?
The maximum length is 3 type-written pages (APA format). Not including cover and references

3.    Reflective Model Exemplar
    Written praxis notes may follow the LEARN format (Look back Elaborate Analyze Revise -New Application of Learning), or you may select another reflective model or framework.

   
    Look Back
-Describe what you did, witnessed, considered or explored this week or over a period of time.
Looking back to our tutorial activity of emergency preparedness during a zombie attach I realize that I was unaware of the role of community health nurses in implementing either contingency plans or like in the activity being part of a committee that makes important decisions with community stakeholders and politicians.
   
Elaborate and Analysis:
-    Discuss what has changed for you from your engagement with your community, your preceptor, your team mate(s), your classmates, your CCD, and through your on-going reading of course materials and literature you yourself are collecting.
After doing this emergency preparedness activity during tutorial, I kept wondering about the role nurses have during an emergency like natural disaster, terrorism or pandemic responses.

-    Critically reflect on your clinical practice (i.e., in this practicum community nursing).
It was unclear for me the place community health nurses have during an emergency. It is clear now:

Public health nurses contribute specific skills in times of disaster. They not only serve as first responders to some events, but also embrace a population-based vision, and have the necessary skills and competencies to develop policies and comprehensive plans, conduct and evaluate disaster response drills, exercises, and trainings. Public health nurses are integral members in emergency operations and command centers, in leadership and management roles, as well as in the field where they provide frontline disaster health and core public health services.

Public health nurses collaborate with other experts,including environmentalists, epidemiologists, laboratory workers, biostatisticians, physicians, social workers, and many others. One of the most exciting
challenges for public health nurses, whether in the emergency management center or in a disaster shelter for hurricane victims, is to collaborate with other emergency workers from other disciplines to enhance the emergency response infrastructure at the local, regional, state, national, and global levels.

Jakeway CC, LaRosa G, Cary A, & Schoenfisch S. (2008). The role of public health nurses in emergency preparedness and response: a position paper of the Association of State and Territorial Directors of Nursing. Public Health Nursing, 25(4), 353361. Retrieved from http://search.ebscohost.com.ezproxy.library.yorku.ca/login.aspx?direct=true&db=rzh&AN=105650362&site=ehost-live

-    What are your current/emerging thoughts and feelings about your community/setting?     
-    What is the difference between your former thinking and behaving and your new thinking and imagination of new behaviour?
I now have a clear understanding of the scope of a community health nurse during an emergency or disaster.
-    What are the most important links for you in this weeks readings, discussions and practicum or praxis groups, what focuses your re-consideration of nursing?
Disaster preparedness should be mandatory in undergraduate nursing education.

these institutions can inculcate a culture of disaster preparedness and mitigation by developing training curricula, promoting educational opportunities and raising awareness of institutional disaster management plans. Second, academic institutions can conduct relevant research and develop capacity-building programmes for healthcare workers and those involved in humanitarian work.15 These measures would create a wealth of resources that could be utilised in national preparedness and response systems through academicpublic health partnerships.16 Disaster preparedness is a critical component of undergraduate education for health professionals. Students must be adequately educated to successfully carry out their roles in disasters as a professional requirement.9 As such, core competencies must be
established and function effectively.

Disaster Preparedness Need for inclusion in undergraduate nursing education doi: 10.18295/squmj.2016.16.01.004

   
    Revision:

-    What is the significance of my learning? (Or So What?)
-    What are the consequences for my nursing practice will my practice change or will it stay the same?
   
    New Application of Learning
-    What am I going to do differently or the same?
-    How am I going to apply what I know now to my community nursing experience?

Assignment Submission: All assignments will adhere to APA guidelines (6th edition) in formatting and referencing.
Minimum 1 Reference.


                                           

Appendix F
Guide to Critical Reflection/Journaling in Praxis

Stages of reflection    Non-reflector                                   Critical Reflector
                  (Fairly                            (exceptional)
                Competent)
Look back and elaborate. Description of situation, thoughts and feelings    Reflection submitted. Relevance of description unclear. Lacks coherence, organization and clarity    Comprehensive, somewhat able to discriminate relevant detail. Ideas link together in a coherent and logical way    Articulates and recollects key features, including context, thoughts and feelings. Clear, logical flow and concise    Consistently captures the essence and importance of the experience. Succinct description of relevant features. Fluent comprehensive, clear and lively
Analysis of experience, thoughts and feelings










Analysis of knowledge    Reflection submitted. Lacks self-awareness. Limited evidence of analysis in the discussion









Little use of previous knowledge. Very limited reading evident    Limited self-awareness. Does not consistently show evidence of analysis or of recognizing the feelings of others








Uses some new and previous knowledge. Limited reading in range and depth    Some constructive exploration of experience, thoughts and feelings. Showa appreciation for how self and others felt, reasons for this and how this influenced the situation






Knowledge sources and their relevance to the situation discussed. Appropriate range of resources    Consistently demonstrates insight into the situation. Frequently asks why? Constructive exploration of experiences, thoughts and feelings. Shows appreciation for how self and others felt, reasons for this and how this influenced the situation

Critically discussed knowledge and literature relevant to the situation and discusses its application to practice. explores own and others assumptions
Analysis of learning
Evidence of learning. pearl of wisdom and its application    Reflection submitted. None or minimal evidence of learning present    Implicit evidence of learning only present    Identifies some learning implications for self as learner, nurse or personal self    Provides explicit evidence of learning. Identifies implications for self as learner, nurse or personal self
Revision and new trial

Application of new learning    Reflection submitted. Application of new learning not demonstrated    Application of new learning vaguely identified    Identifies how this new insight/learning will be used in future situations    Identifies how this new insight/learning will be used in future situations. Insight, creativity, problem-solving and/or critical thinking demonstrated
Identification of further learning    Reflection submitted. No learning gaps/needs identified    Identifies some learning gaps/needs. Rationale and strategies are missing    Identifies through deliberate reflection some learning gaps/needs supported with rationale. Strategies are vaguely articulated    Clearly identifies through deliberate reflection, learning gaps/needs- areas for further learning supported with rationale. Strategies are clearly articulated.
(Adapted from the University of South Australia http://www.unisanet.unisa.edu.au/11755writing/crit-reflect.htm)


Appendix F
Guide to Critical Reflection/Journaling in Praxis

Stages of reflection    Non-reflector                                   Critical Reflector
                  (Fairly                            (exceptional)
                Competent)
Look back and elaborate. Description of situation, thoughts and feelings    Reflection submitted. Relevance of description unclear. Lacks coherence, organization and clarity    Comprehensive, somewhat able to discriminate relevant detail. Ideas link together in a coherent and logical way    Articulates and recollects key features, including context, thoughts and feelings. Clear, logical flow and concise    Consistently captures the essence and importance of the experience. Succinct description of relevant features. Fluent comprehensive, clear and lively
Analysis of experience, thoughts and feelings










Analysis of knowledge    Reflection submitted. Lacks self-awareness. Limited evidence of analysis in the discussion









Little use of previous knowledge. Very limited reading evident    Limited self-awareness. Does not consistently show evidence of analysis or of recognizing the feelings of others








Uses some new and previous knowledge. Limited reading in range and depth    Some constructive exploration of experience, thoughts and feelings. Showa appreciation for how self and others felt, reasons for this and how this influenced the situation






Knowledge sources and their relevance to the situation discussed. Appropriate range of resources    Consistently demonstrates insight into the situation. Frequently asks why? Constructive exploration of experiences, thoughts and feelings. Shows appreciation for how self and others felt, reasons for this and how this influenced the situation

Critically discussed knowledge and literature relevant to the situation and discusses its application to practice. explores own and others assumptions
Analysis of learning
Evidence of learning. pearl of wisdom and its application    Reflection submitted. None or minimal evidence of learning present    Implicit evidence of learning only present    Identifies some learning implications for self as learner, nurse or personal self    Provides explicit evidence of learning. Identifies implications for self as learner, nurse or personal self
Revision and new trial

Application of new learning    Reflection submitted. Application of new learning not demonstrated    Application of new learning vaguely identified    Identifies how this new insight/learning will be used in future situations    Identifies how this new insight/learning will be used in future situations. Insight, creativity, problem-solving and/or critical thinking demonstrated
Identification of further learning    Reflection submitted. No learning gaps/needs identified    Identifies some learning gaps/needs. Rationale and strategies are missing    Identifies through deliberate reflection some learning gaps/needs supported with rationale. Strategies are vaguely articulated    Clearly identifies through deliberate reflection, learning gaps/needs- areas for further learning supported with rationale. Strategies are clearly articulated.
(Adapted from the University of South Australia http://www.unisanet.unisa.edu.au/11755writing/crit-reflect.htm)